72-hour emergency overrides apply to non-preferred drugs on the preferred drug list or drugs subject to clinical prior authorization. Pharmacies will be paid in full for 72-hour emergency prescription claims.
To learn what is required to submit a 72-hour emergency claims, pharmacy staff should refer to the Pharmacy Provider Procedure Manual. A 72-hour emergency prescription claim can be used for people enrolled in either traditional Medicaid or Medicaid managed care:
- Authorization for Traditional Medicaid claims should be directed to the Texas Prior Authorization Call Center.
- Pharmacies submitting claims for people enrolled in Medicaid managed care should refer the prescribing provider to that person's health plan’s prior authorization call center.
We encourage pharmacy staff to review and share the Dispensing 72-hour Emergency Prescriptions instructions and reproduce for staff education.
August 13, 2019
July 2019 Drug Utilization Review Board Meeting Summary
August 9, 2019
Clinical Prior Authorization Assistance Chart Now Available
August 7, 2019
July 2019 Preferred Drug List Recommendations Now Available
July 31, 2019
July 2019 Preferred Drug List Revised July 26
July 22, 2019
July 2019 Preferred Drug List Now Available
July 1, 2019
Drug Utilization Review Board Parking Reminder