Reimbursement Rate Changes and Updates for Certain Texas Medicaid Procedure Codes Effective March 1, 2026
AI Summary
Texas Medicaid is implementing reimbursement rate changes for multiple procedure codes effective March 1, 2026, covering a wide range of services including surgical procedures, diagnostic services, drugs, and medical equipment. The rate changes affect numerous specialties and were determined at a November 2025 public hearing.
Action Required
Before March 1, 2026: Billing team must contact TMHP at 800-925-9126 to obtain specific updated reimbursement rates for affected procedure codes. Update billing software with new Texas Medicaid rates for all affected service categories. For managed care patients, contact individual MCOs to confirm rate changes and administrative procedures as these may differ from fee-for-service rates.
Plan Types
Medicaid
States
TX
Specialties
allergy-immunology, ent, laboratory, ob-gyn, urology, ortho, nuclear-medicine, oncology, pulmonology, radiology, diagnostic-imaging, psychiatry