MedicaidReimbursementMedium impact
Reimbursement Rate Updates for Certain Drug Procedure Codes Effective January 1, 2026
Texas Medicaid·TX·Billing
Effective date
Jan 1, 2026
We identified it
Apr 24, 2026
Summary
Texas Medicaid has revised reimbursement rates for HCPCS drug procedure codes effective January 1, 2026. TMHP will automatically reprocess affected claims, and adjustments will appear in future Remittance and Status (R&S) Reports.
Action Required
By January 1, 2026: Billing team should review the Drug Procedure Codes spreadsheet on the TMHP website to identify which HCPCS drug codes have updated reimbursement rates. Monitor future R&S Reports for automatic claim adjustments from TMHP. Contact TMHP at 800-925-9126 with questions.