MedicaidBilling CodesHigh impact
Coming October 2026: Third Quarter HCPCS Updates to CSHCN Services Program Procedure Codes
Texas Medicaid·TX · Pediatrics·Coding
Effective date
Oct 1, 2026
We identified it
Aug 6, 2026
Summary
Effective October 1, 2026, Texas Medicaid will implement HCPCS procedure code updates for the CSHCN Services Program, including additions, revisions, and discontinuations. Discontinued codes will no longer be covered benefits. New codes will not be reimbursed until HHSC completes rate hearings and notifies providers of benefit changes.
Action Required
By September 15, 2026: Billing team must obtain the specific list of discontinued, added, and revised HCPCS codes from TMHP or the updated CSHCN Services Program Provider Manual and map them in the billing system. Before October 1, 2026: Remove discontinued codes from billing templates and disable them in billing software to prevent claims submission. Update claim scrubbing rules to reject any claims using deleted codes. Monitor for future HHSC notifications regarding new code reimbursement rates and benefit coverage. Contact TMHP-CSHCN Services Program Contact Center at 800-568-2413 for the complete code change list. Failure to remove discontinued codes will result in claim denials.