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Texas MedicaidMedicaid · Reimbursement · Fee Schedule · TX · Emergency Medicine, Critical CareHigh impact

Reimbursement Rate Updates for Ambulance Procedure Codes Effective September 1, 2026

Act
by Aug 15, 2026
Effective date
Sep 1, 2026
Identified
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.

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What to do

by Aug 15, 2026 · 6 steps
01Billing team must download and review the Ambulance spreadsheet from TMHP to identify all affected ambulance procedure codes and their new reimbursement rates.
02Update billing software fee schedules in the system to reflect new rates for all ambulance codes effective September 1, 2026.
03Contact the specific MCO(s) that your practice works with to confirm prior authorization, precertification, and claims filing procedures—these may differ from traditional Medicaid.
04Communicate rate changes to dispatch and clinical staff.
05Failure to update rates by the effective date will result in underbilling and claim denials.
06For code-specific details, contact TMHP Contact Center at 800-925-9126.

Original notice

Reimbursement Rate Updates for Ambulance Procedure Codes Effective September 1, 2026
tmhp.com · Always check the source before changing claims.
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Related changes

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Texas Medicaid policiesTX policy changesEmergency MedicineCritical Care

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