MedicaidReimbursementHigh impact
Reimbursement Rate Updates for DME and Enteral Supplies Procedure Codes Effective September 1, 2026
Texas Medicaid·TX · Physical Therapy, Occupational Therapy, Speech Therapy +1 more·Fee Schedule
Effective date
Sep 1, 2026
We identified it
Jul 18, 2026
Summary
Texas Medicaid (TMHP) is implementing reimbursement rate changes for durable medical equipment (DME) and enteral supplies procedure codes effective September 1, 2026. Billing teams must obtain and review the updated fee schedules from linked spreadsheets to ensure accurate claim submission and reimbursement. Rates for these supply categories will change, requiring system updates and potential claim adjustments.
Action Required
By August 31, 2026: Billing team must download and review the DME and Enteral Supplies reimbursement rate spreadsheets from TMHP (https://www.tmhp.com/news/2026-07-17-reimbursement-rate-updates-dme-and-enteral-supplies-procedure-codes-effective). Extract all affected HCPCS codes and their new rates. Update billing system fee schedule tables and charge capture templates to reflect new rates effective September 1, 2026. Verify that all claims submitted on or after September 1, 2026 use updated rates. Contact individual MCOs to confirm if managed care organizations have different rate implementations. Failure to update rates may result in underbilling or claim denials for rate mismatches.