TX Medicaid Aduhelm (aducanumab-avwa)

Texas Medicaid covers aducanumab‑avwa (Aduhelm™, J0172) for Medicaid clients with a confirmed diagnosis of Alzheimer’s disease (G300, G301, G308, G309) who have documented amyloid‑beta plaques and mild cognitive impairment or mild‑stage AD (dual-eligibles must follow Medicare NCD rules). Prior authorization is required with a baseline brain MRI (within the past year) and serial MRIs (including before the 5th, 7th, 9th and 12th infusions) to monitor ARIA, no concurrent anticoagulant use except low‑dose aspirin, initial approval up to 6 months, and renewal only if there is radiographic stabilization/no increase in amyloid, no progression to moderate/severe dementia, and no unacceptable toxicities.

"Prescriber's confirmation of amyloid beta-plaques presence."

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