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Texas MedicaidMedicaid · Reimbursement · Pharmacy · TX · Pharmacy, PediatricsMedium impact

Reimbursement Rate Updates for HCPCS Drug Procedure Code J8502 Effective April 1, 2026

Act
by Mar 15, 2026
Effective date
Apr 1, 2026
Identified
Aug 6, 2026

Summary

Texas Medicaid (TMHP) has updated reimbursement rates for HCPCS code J8502 effective April 1, 2026. The new rates apply to the Children with Special Health Care Needs (CSHCN) Services Program. TMHP will automatically identify and reprocess affected claims, with adjustments appearing on future Remittance and Status Reports.

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What to do

by Mar 15, 2026 · 5 steps
01Billing team must obtain the updated Drug Procedure Code J8502 spreadsheet from TMHP to identify the new reimbursement rates.
02Update billing system fee schedules and claim edits to reflect the new J8502 rates for all claims with dates of service on or after April 1, 2026.
03Communicate the rate change to clinical staff billing for CSHCN Services Program patients.
04Monitor upcoming Remittance and Status Reports for any claim adjustments related to this rate update.
05Contact TMHP at 800-925-9126 if clarification is needed on specific rate amounts or application rules.

Codes mentioned

J8502

Original notice

Reimbursement Rate Updates for HCPCS Drug Procedure Code J8502 Effective April 1, 2026
tmhp.com · Always check the source before changing claims.
View original ↗

Related changes

See all Texas Medicaid changes →
First Quarter 2026 HCPCS Updates for Texas MedicaidHighEffective Apr 1, 2026 · CodingFirst Quarter 2026 HCPCS Updates for the CSHCN Services ProgramHighEffective Apr 1, 2026 · CodingReimbursement Rate Updates for Certain CSHCN HCPCS Drug Procedure Codes Effective July 1, 2026MediumEffective Jul 1, 2026 · PharmacyReimbursement Rate Updates for Certain CSHCN HCPCS Drug Procedure Codes Effective April 1, 2026MediumEffective Apr 1, 2026 · PharmacyBrowse every Texas Medicaid change in the policy list

Related policy hubs

Texas Medicaid policiesTX policy changesPharmacyPediatricsCode J8502

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