MedicaidCoverageMedium impact
Age Restriction to Be Updated in the TMPPM for Secukinumab (Cosentyx)
Texas Medicaid·TX · Rheumatology, Dermatology, Gastroenterology·General
Effective date
Jun 1, 2026
We identified it
May 16, 2026
Summary
Texas Medicaid is updating the age restriction for secukinumab (Cosentyx) injections from 2 years of age or older to 18 years of age or older, effective June 1, 2026. This change aligns with FDA labeling and will affect coverage for pediatric patients currently receiving this medication.
Action Required
By June 1, 2026: Billing team must update system to restrict HCPCS code J3247 (secukinumab/Cosentyx) billing to patients 18 years and older for Texas Medicaid. Review current pediatric patients aged 2-17 receiving Cosentyx and coordinate with providers for alternative treatments before the effective date. Update age verification protocols for this medication.