Procedure Code(s) Must Now Be Listed on Radiology Prior Authorization Request Form

Immediately (retroactive to July 23, 2026): Billing team must update all radiology prior authorization workflows to require procedure codes in Section B of the Radiology Prior Authorization Request Form before submission. (1) Modify billing software templates and encounter forms to mandate procedure code entry as a required field for radiology prior auth requests. (2) Brief all providers, clinical staff, and billing personnel that radiology prior authorizations to Texas Medicaid MCOs will be DENIED without procedure codes listed. (3) Audit any pending or recently submitted radiology prior auth requests to Texas Medicaid MCOs submitted since July 23, 2026—resubmit with procedure codes if missing. (4) Contact the specific MCO for the patient to verify form requirements, as procedures may vary between MCOs (TMHP Contact Center: 800-925-9126). Consequence: Claims for radiology services will be denied if prior authorization was not granted due to missing procedure codes.