Texas MedicaidMedium ImpactReimbursement
Reimbursement Rate Updates for Certain Drug Procedure Codes Effective January 1, 2026
Published May 1, 2026Effective January 1, 2026
AI Summary
TMHP has revised reimbursement rates for HCPCS drug procedure codes effective January 1, 2026. Providers can view the updated rates in the Drug Procedure Codes spreadsheet, and TMHP will automatically reprocess affected claims with adjustments appearing in future R&S reports.
Action Required
By January 1, 2026: Billing team should review the Drug Procedure Codes spreadsheet on TMHP website to identify updated reimbursement rates for HCPCS drug codes. Monitor future Remittance and Status (R&S) Reports for automatic claim adjustments. Contact TMHP at 800-925-9126 for questions about reprocessed claims.
Plan Types
Medicaid
States
TX
Specialties
all-specialties