MedicaidAdministrativeHigh impact
Long-Term Care Providers Fiscal Year 2026 Year-End Closeout Claim/Payment Processing Schedule
Texas Medicaid·TX · Geriatrics·Billing
Effective date
Aug 4, 2026
We identified it
Jul 28, 2026
Summary
Texas TMHP has released an urgent fiscal year-end closeout schedule for Long-Term Care providers. Claims with dates of service in FY 2024 (9/1/2023–8/31/2024) must be approved and paid by August 4, 2026, or they will convert to Miscellaneous Claims with severely restricted payment eligibility. Additionally, FY 2025–2026 claim processing will be temporarily paused during state closeout and the Labor Day holiday, with specific submission deadlines and warrant distribution dates in late August and early September 2026.
Action Required
By August 4, 2026: Billing team must identify and submit all pending claims with DOS in FY 2024 (9/1/2023–8/31/2024) to avoid Miscellaneous Claims classification. Immediately: Review all open FY 2024 DOS claims for payment status using Remittance and Status (R&S) reports and escalate any unresolved issues to HHSC Provider Claims Services at (512) 438-2200, Option 1. By August 21, 2026: Submit all FY 2025–2026 DOS claims to TMHP by noon to meet the August 26 warrant issuance date; coordinate with EDI submitters/clearinghouses to ensure claims arrive before deadline (allow 24 hours for EDI batch processing). Ongoing: Ensure all billing is complete within the 12-month filing deadline—claims submitted or adjusted more than 12 months after DOS will be denied for untimely filing. Reconcile all R&S reports carefully and report any invalid recoupment claims to HHSC Provider Recoupments and Holds at (512) 438-2200, Option 3. Failure to meet deadlines will result in claim conversion to Miscellaneous status, which restricts payment eligibility to claims under $50,000 with services less than 8 years old on a first-come, first-served basis; claims over $50,000 or with services older than 8 years cannot be paid except through special legislative budget line items.