MedicaidReimbursementMedium impact
Reimbursement Rate Updates for Certain CSHCN Services Program HCPCS Drug Procedure Codes Effective January 1, 2026
Texas Medicaid·TX · Pediatrics·Billing
Effective date
Jan 1, 2026
We identified it
May 2, 2026
Summary
Texas Medicaid has updated reimbursement rates for HCPCS drug procedure codes under the CSHCN Services Program, effective January 1, 2026. TMHP will automatically reprocess affected claims and adjustments will appear in future R&S Reports.
Action Required
Before January 1, 2026: Billing team should review the Drug Procedure Codes spreadsheet on TMHP website to identify which HCPCS drug codes have updated rates for CSHCN program patients. Monitor future R&S Reports for automatic claim reprocessing adjustments. Contact TMHP at 800-925-9126 for questions about specific rate changes.