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Effective September 30, 2025: New Prior Authorization Requirement for Certain Bathroom Commode Chairs

Date: 06/23/25

Superior HealthPlan will require prior authorization for procedure code E0165 commode chairs for Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS), and CHIP members. Superior will utilize the Texas Medicaid Provider Procedures Manual as the medical necessity review criteria.

Superior ensures medical necessity review criteria is current and appropriate for members and the scope of services provided, as a result, the following code update is effective on September 30, 2025.

Procedure Code

Applicable Products

Criteria

E0165 - commode chair, mobile or stationary with detachable arms

Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS), CHIP

Texas Medicaid Provider Procedures Manual

To review prior authorization requirements, please visit Superior’s Prior Authorization webpage.

For questions or additional information, contact Superior’s Prior Authorization department at 1-800-218-7508.