Texas MedicaidMedium ImpactCoverage

June 2026 CSHCN Services Program Provider Manual Updates for “Physician” Chapter

Published April 18, 2026Effective June 15, 2026

AI Summary

Effective June 15, 2026, CPT code 99360 will be removed from the CSHCN Services Program Provider Manual's Physician chapter as it is not a covered benefit. This affects critical care services and prolonged physician services sections in the manual.

Action Required

By June 15, 2026: Billing team must stop billing CPT code 99360 for all CSHCN Services Program patients. Remove code 99360 from billing software templates for critical care services and prolonged physician services. Update encounter forms to remove references to this code for CSHCN patients. Contact TMHP-CSHCN at 800-568-2413 with questions.

Affected Billing Codes

99360

Plan Types

Medicaid

States

TX

Specialties

family-medicine, internal-medicine, pediatrics, critical-care