Texas MedicaidMedium ImpactReimbursement

Reimbursement Rate Updates for Certain CSHCN Procedure Codes Effective July 1, 2026

Published May 14, 2026Effective July 1, 2026

AI 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.

Plan Types

Medicaid

States

TX

Specialties

laboratory, ent, ob-gyn

Reimbursement Rate Updates for Certain CSHCN Procedure Codes Effective July 1, 2026 | Texas Medicaid | PolicyChanges.app