MedicaidReimbursementMedium impact
Reimbursement Rate Updates for Certain CSHCN Procedure Codes Effective July 1, 2026
Texas Medicaid·TX · ENT (Ear, Nose & Throat), OB-GYN·Billing
Effective date
Jul 1, 2026
We identified it
May 14, 2026
Summary
The Texas Children with Special Health Care Needs (CSHCN) Services Program is updating reimbursement rates for certain procedure codes in Clinical Laboratory Services, ENT, and Female Genital System Surgery categories effective July 1, 2026.
Action Required
Before July 1, 2026: Billing team must review the CSHCN reimbursement rate spreadsheets for Clinical Laboratory Services, ENT, and Female Genital System Surgery procedures. Update billing system with new rates for affected CSHCN patients. Contact TMHP-CSHCN Contact Center at 800-568-2413 for clarification if needed.