Texas MedicaidMedium ImpactBilling Codes
First Quarter NCCI Updates Effective January 1, 2026
Published January 12, 2026Effective January 1, 2026
AI Summary
Texas Medicaid will implement first quarter NCCI updates effective January 1, 2026, with system implementation on January 25, 2026. Claims processed between January 1-24, 2026 will be automatically reprocessed, potentially resulting in payment adjustments for NCCI code pairs and Medically Unlikely Edits.
Action Required
By January 25, 2026: Billing team must regularly monitor the CMS Medicaid NCCI web page for updated code pair relationships and MUE limits. Review reprocessed claims from January 1-24, 2026 for payment adjustments. Update billing system with new NCCI edits to prevent future denials. Contact TMHP at 800-925-9126 for questions about claim adjustments.
Plan Types
Medicaid
States
TX
Specialties
all-specialties