Texas MedicaidMedium ImpactReimbursement

Update to “Correction to ‘Reimbursement Rate Changes and Updates for Certain Texas Medicaid Procedure Codes Effective September 1, 2025’”

Published January 15, 2026Effective September 1, 2025

AI Summary

Texas Medicaid corrected reimbursement rates for cardiovascular services at rural hospitals, with multiple procedure categories getting updated rates effective September 1, 2025. TMHP will automatically reprocess affected claims and adjustments will appear on future remittance reports.

Action Required

No immediate action required - TMHP will automatically identify and reprocess affected claims. Monitor future Remittance and Status (R&S) Reports for reimbursement adjustments. Contact TMHP at 800-925-9126 for questions about specific procedure code rate changes.

Plan Types

Medicaid

States

TX

Specialties

cardiology, gastroenterology, nephrology, laboratory, diagnostic-imaging, all-specialties