MedicaidBilling CodesMedium impact
Coming April 2026: First Quarter HCPCS Updates to CSHCN Services Program Procedure Codes
Texas Medicaid·TX · Pediatrics·Coding
Effective date
Apr 1, 2026
We identified it
Feb 14, 2026
Summary
Starting April 1, 2026, TMHP will implement HCPCS code updates for the CSHCN Services Program based on CMS first quarter changes. Discontinued codes will no longer be covered benefits, while new codes won't be reimbursed until HHSC reviews them and holds rate hearings.
Action Required
By March 31, 2026: Billing team must review the CSHCN Services Program Provider Manual for updated benefit information and verify which HCPCS codes are discontinued. Stop billing any discontinued codes for CSHCN patients effective April 1st. Monitor for future notifications about new code reimbursement status. Contact TMHP-CSHCN at 800-568-2413 for clarification on specific codes.