MedicaidReimbursementHigh impact
Reimbursement Rate Updates for Ambulance Procedure Codes Effective September 1, 2026
Texas Medicaid·TX · Emergency Medicine, Critical Care·Fee Schedule
Effective date
Sep 1, 2026
We identified it
Jul 18, 2026
Summary
Texas Medicaid (TMHP) is implementing reimbursement rate changes for ambulance procedure codes effective September 1, 2026. Specific rate updates are contained in a linked spreadsheet that must be reviewed and integrated into billing systems. The policy also clarifies that MCOs may have different prior authorization and administrative requirements than traditional Medicaid.
Action Required
By August 15, 2026: Billing team must download and review the Ambulance spreadsheet from TMHP to identify all affected ambulance procedure codes and their new reimbursement rates. Update billing software fee schedules in the system to reflect new rates for all ambulance codes effective September 1, 2026. Contact the specific MCO(s) that your practice works with to confirm prior authorization, precertification, and claims filing procedures—these may differ from traditional Medicaid. Communicate rate changes to dispatch and clinical staff. Failure to update rates by the effective date will result in underbilling and claim denials. For code-specific details, contact TMHP Contact Center at 800-925-9126.