Texas MedicaidMedium ImpactReimbursement

Reimbursement Rate Updates for Syphilis Testing Procedure Code 86593 Effective May 1, 2025, for FPP

Published January 27, 2026Effective May 1, 2025

AI Summary

Texas Medicaid is updating reimbursement rates for syphilis testing procedure code 86593 under the Family Planning Program, effective May 1, 2025. TMHP will automatically reprocess affected claims and adjustments will appear on future Remittance and Status Reports.

Action Required

Before May 1, 2025: Billing team should review the FPP Syphilis Testing procedure code spreadsheet for updated reimbursement rates for CPT 86593. Monitor future Remittance and Status Reports for automatic claim reprocessing adjustments. Contact TMHP at 800-925-9126 if questions arise about claim reprocessing.

Affected Billing Codes

86593

Plan Types

Medicaid

States

TX

Specialties

family-medicine, ob-gyn, internal-medicine, infectious-disease