Texas MedicaidMedium ImpactBilling Codes

May 2026 TMPPM Update for Colony Stimulating Factors

Published April 13, 2026Effective May 1, 2026

AI Summary

Texas Medicaid will add filgrastim-txid (Nypozi) with procedure code Q5148 to their covered colony stimulating factors effective May 1, 2026. This biosimilar drug will be covered alongside existing filgrastim and pegfilgrastim options.

Action Required

By May 1, 2026: Billing team must update billing system to include new HCPCS code Q5148 for filgrastim-txid (Nypozi) biosimilar. Add code to drug formulary lists and ensure claims processing system recognizes the new code for Texas Medicaid patients. Contact individual MCOs for specific administrative requirements.

Affected Billing Codes

Q5148

Plan Types

Medicaid

States

TX

Specialties

oncology, hematology