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2026-2027 ICD-10 Special Bulletin Now Available
Effective date
Oct 1, 2026
Identified
Oct 2, 2026
Summary
Texas Medicaid has released the 2027 ICD-10 updates effective October 1, 2026, including new and modified diagnosis codes (ICD-10-CM) and procedure codes (ICD-10-PCS). The billing team must prepare to implement these code changes in their systems and billing workflows before the effective date. Updated provider manuals will be released in November 2026.
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What to do
Action · 8 steps
01Before October 1, 2026: Billing team must obtain the complete 2027 ICD-10-CM and ICD-10-PCS code updates from the TMHP Rate and Code Updates page (tmhp.com).
02Update billing software, encoder tools, and charge masters with all new, modified, and deleted codes.
03Review the November 2026 Texas Medicaid Provider Procedures Manual (TMPPM) and CSHCN Services Program Provider Manual upon release to identify any Texas Medicaid-specific coding guidance.
04Train clinical and billing staff on code changes applicable to your specialties.
05Verify that all encounter forms and EMR templates reflect the updated codes.
06For managed care plans, contact each MCO separately to confirm their implementation timeline and any MCO-specific coding requirements, as these may differ from fee-for-service Medicaid.
07Failure to implement correct codes by October 1, 2026 will result in claim denials and payment delays.
08Contact TMHP Contact Center (800-925-9126) or TMHP-CSHCN Services Program Contact Center (800-568-2413) with questions.
Original notice
2026-2027 ICD-10 Special Bulletin Now Available
tmhp.com · Always check the source before changing claims.