MedicaidReimbursementMedium impact
Reimbursement Rate Updates for HCPCS Drug Procedure Code J8502 Effective April 1, 2026
Texas Medicaid·TX · Pharmacy, Pediatrics·Pharmacy
Effective date
Apr 1, 2026
We identified it
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.
Action Required
By March 15, 2026: Billing team must obtain the updated Drug Procedure Code J8502 spreadsheet from TMHP to identify the new reimbursement rates. Update 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. Communicate the rate change to clinical staff billing for CSHCN Services Program patients. Monitor upcoming Remittance and Status Reports for any claim adjustments related to this rate update. Contact TMHP at 800-925-9126 if clarification is needed on specific rate amounts or application rules.