Texas MedicaidMedium ImpactBilling Codes
Limitation Update to the CSHCN Services Program Provider Manual for Immune Globulins
Published January 31, 2026Effective April 1, 2026
AI Summary
Starting April 1, 2026, Texas Medicaid's CSHCN Services Program will only reimburse one of the three immune globulin procedure codes (J1571, J1573, or 90371) when billed on the same date of service by any provider. This prevents duplicate billing for immune globulin treatments.
Action Required
By April 1, 2026: Billing team must update system to flag and prevent billing multiple immune globulin codes (J1571, J1573, 90371) on the same date of service for CSHCN patients. Update billing edits to allow only one code per date. Train staff that only one immune globulin code will be reimbursed per day regardless of provider.
Affected Billing Codes
J1571J157390371
Plan Types
Medicaid
States
TX
Specialties
allergy-immunology, pediatrics, hematology, neurology, infectious-disease