Texas MedicaidMedium ImpactBilling Codes
May 2026 TMPPM Update for Immunosuppressive Drugs
Published April 13, 2026Effective May 1, 2026
AI Summary
Texas Medicaid is adding coverage for Mycophenolate mofetil (HCPCS code J7528) to the Immunosuppressive Drugs section, effective May 1, 2026. This drug is used to prevent organ rejection in kidney, liver, and heart transplant patients.
Action Required
By May 1, 2026: Billing team must update billing system to include HCPCS code J7528 for Mycophenolate mofetil administration. Add code to immunosuppressive drug inventory and encounter forms. Contact patient's specific MCO for prior authorization requirements as administrative procedures may differ between MCOs.
Affected Billing Codes
J7528
Plan Types
Medicaid
States
TX
Specialties
nephrology, gastroenterology, cardiothoracic-surgery, general-surgery, oncology