MedicaidCoverageMedium impact
Prescription Requirement for At-Home COVID-19 Test Kits Begins July 1, 2026
Texas Medicaid·TX · Pharmacy·Pharmacy
Effective date
Jul 1, 2026
We identified it
Jul 4, 2026
Summary
Effective July 1, 2026, Texas Medicaid and CHIP will require a prescription for at-home COVID-19 test kits dispensed through the outpatient drug benefit. Previously, these kits were covered without a prescription under federal regulation. The monthly limit of four test kits per month remains unchanged. This change applies to both fee-for-service and managed care Medicaid/CHIP plans in Texas.
Action Required
By June 30, 2026: (1) Billing team must update pharmacy billing system to require a valid prescription before dispensing at-home COVID-19 test kits for Texas Medicaid and CHIP beneficiaries. (2) Pharmacy staff must implement workflow changes to verify prescription documentation at point of dispensing. (3) Providers must be notified that standing orders or physician collaborative practice agreements per Texas state law and regulation may be used to fulfill this requirement. (4) Update all internal guidance documents and training materials to reflect the new prescription requirement. (5) Coordinate with EMR/pharmacy systems to flag COVID-19 test kit claims lacking prescription documentation. Failure to obtain prescriptions will result in claim denials for Texas Medicaid and CHIP members.