MedicaidReimbursementMedium impact
Reimbursement Rate Updates for Certain HCPCS Procedure Codes Effective January 1, 2026, for Texas Medicaid
Texas Medicaid·TX·Coding
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Texas Medicaid has implemented reimbursement rate updates for certain HCPCS procedure codes effective January 1, 2026, covering Durable Medical Equipment (TOS 9-J-L) and Non-Drugs (TOS 1). TMHP will automatically identify and reprocess affected claims, with adjustments appearing on future Remittance and Status Reports.
Action Required
By April 28, 2026: Monitor Remittance and Status Reports for automatic claim adjustments from TMHP reprocessing. No immediate action required as TMHP will automatically identify and reprocess affected claims. Contact TMHP at 800-925-9126 if questions arise about reimbursement adjustments for Durable Medical Equipment or Non-Drug procedure codes.