Texas MedicaidMedium ImpactReimbursement
Reimbursement Rate Updates for Certain Drug Procedure Codes Effective October 1, 2025
Published January 12, 2026Effective October 1, 2025
AI Summary
Texas Medicaid has updated reimbursement rates for HCPCS drug procedure codes effective October 1, 2025. TMHP will automatically reprocess affected claims and adjustments will appear on future Remittance and Status Reports.
Action Required
By October 1, 2025: Billing team should review the Drug Procedure Codes spreadsheet on TMHP website to identify which drug codes have updated reimbursement rates. Monitor future R&S Reports for automatic claim adjustments from TMHP reprocessing. Contact TMHP at 800-925-9126 for questions about specific rate changes.
Plan Types
Medicaid
States
TX
Specialties
all-specialties