MedicaidReimbursementMedium impact
Reimbursement Rate Updates for Certain CSHCN HCPCS Procedure Codes Effective January 1, 2026
Texas Medicaid·TX·Billing
Effective date
Jan 1, 2026
We identified it
Jun 3, 2026
Summary
Texas Medicaid & Healthcare Partnership (TMHP) is implementing reimbursement rate updates for certain HCPCS procedure codes under the Children with Special Health Care Needs (CSHCN) Services Program effective January 1, 2026. TMHP will automatically identify and reprocess affected claims, with adjustments appearing on future Remittance and Status (R&S) Reports.
Action Required
Before January 1, 2026: Billing team should review the TMHP spreadsheets for updated reimbursement rates across multiple service categories (ASC, lab, dental, DME, radiology, surgery). Monitor future R&S Reports for automatic claim reprocessing adjustments. Contact TMHP-CSHCN at 800-568-2413 for questions about rate changes.