Texas MedicaidMedium ImpactReimbursement

Reimbursement Rate Updates for Biomarker Procedure Codes Effective May 1, 2026

Published May 9, 2026Effective May 1, 2026

AI Summary

Texas Medicaid is implementing reimbursement rate changes for biomarker procedure codes effective May 1, 2026. TMHP will automatically reprocess affected claims and adjustments will appear in future remittance reports.

Action Required

By May 1, 2026: Billing team should access the Biomarkers spreadsheet from TMHP to review specific rate changes for biomarker procedure codes. Monitor future Remittance and Status (R&S) Reports for automatic claim adjustments. Contact TMHP at 800-925-9126 for questions about rate changes.

Plan Types

Medicaid

States

TX

Specialties

oncology, pathology, laboratory