Coming July 2026: Second Quarter HCPCS Updates to CSHCN Services Program Procedure Codes
AI Summary
Texas Medicaid will implement HCPCS code updates on July 1, 2026, affecting the Children with Special Health Care Needs (CSHCN) Services Program. Some procedure codes will be discontinued and no longer covered, while new codes will be added but not reimbursed until rate hearings are completed.
Action Required
By July 1, 2026: Billing team must monitor for future TMHP notifications identifying specific discontinued and added HCPCS codes for CSHCN Services Program. Review CSHCN Services Program Provider Manual for current benefit information. Contact TMHP-CSHCN Services Program Contact Center at 800-568-2413 for clarification on specific code changes. Stop billing any discontinued codes effective July 1, 2026, and do not bill new codes until rate hearings are completed and reimbursement is approved.
Plan Types
Medicaid
States
TX
Specialties
pediatrics, all-specialties