Pharmacy Enrollment Resources
- Enrollment Forms
- Pharmacy Provider Procedure Manual
- Pharmacy Provider Payer Sheets
- Eligibility Verification
- Pharmacy Eligibility Verification Portal Access (HHS Form 1317)
- Pharmacy Payment
- Pharmacy Electronic Remittance Advice Agreement (HHS Form 1316)
Managed Care Resources
- Pharmacy Enrollment Chart (PDF)
- Pharmacy Assistance Chart (PDF)
- Prescriber Assistance Chart (PDF)
- Service Delivery Area Assistance Chart (PDF)
Drug and Product Resources
- Drug Addition Process Overview
- The Texas Medicaid program covers most outpatient prescription drugs either through a Medicaid managed care organization (MCO) or through the Vendor Drug Program (VDP). The HHSC Drug Addition Process (PDF) provides a high-level summary of the process that occurs prior to adding drugs to the Texas Medicaid formulary.
- Texas Drug Code Index Certification of Information (HHS Form 1326)
- Drug Shortage Notification (HHS Form 1315)
- Specialty drug list
- Clinician-administered drug resources
- Long-acting reversible contraception product resources
- Mosquito Repellent Benefit
Prior Authorization
- Non-preferred
- Clinical
- Forms
- Texas Prior Authorization Call Center
Drug Rebates
Drug Utilization Review Board
Education and Training Materials
- 72-hour Emergency Override Instructions (PDF)
- Texas Medicaid Pharmacy Benefits brochure (PDF)
- Continuing Education flyer (PDF)
- Getting Started with Electronic Prescribing of Controlled Substances (PDF)
Claim Forms
- Pharmacy Retroactive Claim Form (HHS Form 1318)
- Pharmacy Claims Billing Request (HHS Form 1319)