Texas MedicaidMedium ImpactCoverage

Update to TMPPM and the CSHCN Services Program Provider Manual for Texas Health Steps and CSHCN Dental Anesthesia Services

Published January 31, 2026Effective April 1, 2026

AI Summary

Effective April 1, 2026, Texas Medicaid will limit dental anesthesia procedure codes D9210, D9211, D9212, and D9230 to one per day, same procedure, same place of service, by the same provider on the same claim. This affects Texas Health Steps and CSHCN dental services billing.

Action Required

Before April 1, 2026: Billing team must update system rules to prevent multiple billing of dental anesthesia codes D9210, D9211, D9212, and D9230 on the same day for the same patient by the same provider at the same location. Update encounter forms to alert dental providers of the one-per-day limitation. Multiple claims for the same procedure code on the same day will be denied.

Affected Billing Codes

D9210D9211D9212D9230

Plan Types

Medicaid

States

TX

Specialties

dentistry