Updated October 04, 2023
A Texas Medicaid prior authorization form requests Medicaid coverage of a non-preferred drug in the State of Texas (a fillable PDF version of this form can be downloaded here). A non-preferred drug is a drug that does not appear on the State-approved Preferred Drug List. For more information, call one of the phone numbers provided below.
Texas Prior Authorization Call Center Phone Number – 1 (877) 728-3927
Texas Medicaid Phone Number – 1 (800) 925-9126
Preferred Drug List (PDL)