MedicaidCoverageMedium impact
August 2026 TMPPM Update for Clinician Administered Drug Vitamin B12 (Cyanocobalamin) Injection
Texas Medicaid·TX · Family Medicine, Internal Medicine, General Practice +5 more·Pharmacy
Effective date
Aug 1, 2026
We identified it
Jun 20, 2026
Summary
Effective August 1, 2026, Texas Medicaid will remove all diagnosis restrictions for Vitamin B12 (cyanocobalamin) injection procedure code J3420. The injections will still be covered but should only be used for patients who cannot take or do not respond to oral B12 therapy.
Action Required
By August 1, 2026: Billing team must update Texas Medicaid billing rules to remove diagnosis restrictions for procedure code J3420 (Vitamin B12 injections). Ensure providers document that oral therapy is contraindicated or ineffective before administering injections. Update encounter forms and EMR templates to include this documentation requirement.