MedicaidReimbursementMedium impact
Reimbursement Rate Updates for Biomarker Procedure Codes Effective May 1, 2026
Texas Medicaid·TX · Oncology, Pathology·Billing
Effective date
May 1, 2026
We identified it
May 9, 2026
Summary
Texas Medicaid is implementing reimbursement rate changes for biomarker procedure codes effective May 1, 2026. TMHP will automatically reprocess affected claims and adjustments will appear in future remittance reports.
Action Required
By May 1, 2026: Billing team should access the Biomarkers spreadsheet from TMHP to review specific rate changes for biomarker procedure codes. Monitor future Remittance and Status (R&S) Reports for automatic claim adjustments. Contact TMHP at 800-925-9126 for questions about rate changes.