Texas MedicaidMedium ImpactReimbursement
Reimbursement Rate Updates for Certain HCPCS Procedure Codes Effective January 1, 2026, for Texas Medicaid
Published May 22, 2026Effective January 1, 2026
AI Summary
Texas Medicaid has implemented reimbursement rate updates for certain HCPCS procedure codes, affecting Durable Medical Equipment (TOS 9-J-L) and Non-Drugs (TOS 1) services. TMHP will automatically identify and reprocess affected claims with adjustments appearing on future Remittance and Status Reports.
Action Required
By April 28, 2026: Billing team should monitor Remittance and Status (R&S) Reports for claim adjustments from automatic reprocessing. Contact TMHP at 800-925-9126 for specific questions about reimbursement rate changes. No immediate system updates required as TMHP will handle claim reprocessing automatically.
Plan Types
Medicaid
States
TX
Specialties
all-specialties