Effective December 8, 2025: Bariatric Surgical Procedures
Date: 11/07/25
Superior HealthPlan will utilize the Texas Medicaid Provider Procedures Manual as the medical necessity review criteria for Bariatric Surgical Procedures for Superior Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS) members effective December 8, 2025.
Superior ensures medical necessity review criteria are current and appropriate for members and the scope of services provided.
Procedure | Applicable Products | Criteria |
Bariatric Surgical Procedures | Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS) |
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.