MedicaidReimbursementMedium impact
Reimbursement Rate Updates for MTP Procedure Code S0215 Effective July 1, 2026
Texas Medicaid·TX·Fee Schedule
Effective date
Jul 1, 2026
We identified it
Sep 3, 2026
Summary
Texas Medicaid has updated reimbursement rates for medical transportation program (MTP) procedure code S0215, effective July 1, 2026. TMHP will automatically reprocess affected claims, and providers should not appeal unless claims are denied for additional reasons after reprocessing. Billing teams must verify updated rates in the Medical Transportation Program spreadsheet and ensure claims submitted on or after July 1, 2026 reflect the new reimbursement amounts.
Action Required
By June 30, 2026: Billing team must obtain and review the updated Medical Transportation Program spreadsheet from TMHP to identify the new reimbursement rates for S0215. Update billing system fee schedules in the Texas Medicaid module to reflect the new rates effective July 1, 2026. Verify that all claims with dates of service on or after July 1, 2026 bill at the updated rates. Notify providers that TMHP will automatically reprocess affected claims identified by the payer; staff should not submit manual appeals unless claims receive additional denial reasons post-reprocessing. For MCO-enrolled members, contact the specific MCO to confirm their S0215 reimbursement rates and any prior authorization or administrative requirements, as MCO policies may differ from fee-for-service Medicaid. Contact TMHP at 800-925-9126 if clarification is needed on the new rates.