MedicaidReimbursementMedium impact
FMAP and EFMAP to Change on October 1, 2026
Texas Medicaid·TX·General
Effective date
Oct 1, 2026
We identified it
Sep 11, 2026
Summary
Effective October 1, 2026, Texas Medicaid's Federal Medical Assistance Percentage (FMAP) will decrease from 59.83% to 58.54%, and the Enhanced EFMAP will decrease from 71.88% to 70.98%. Only providers that certify expenses and receive only the federal share will see reimbursement adjustments; EFMAP changes will not affect provider payments.
Action Required
By September 30, 2026: Billing team must identify which providers at this practice certify expenses and receive only the federal share of claims from Texas Medicaid. Coordinate with practice leadership and Texas Medicaid (TMHP Contact Center: 800-925-9126) to understand how the 1.29 percentage point FMAP reduction (59.83% to 58.54%) will impact reimbursement for these providers. Update revenue projections and budget forecasts accordingly for the fiscal year beginning October 1, 2026. Document the change in billing system notes for reference during claims processing. No immediate workflow changes are required for providers not affected by FMAP (those receiving both federal and state shares).