MedicaidCoverageMedium impact
Texas Medicaid to Update Immunosuppressive Drug Indications on March 1, 2026
Texas Medicaid·TX · Gastroenterology, Rheumatology, Internal Medicine·Pharmacy
Effective date
Mar 1, 2026
We identified it
Jan 17, 2026
Summary
Texas Medicaid will no longer cover ulcerative colitis as an indication for immunosuppressive drug code J0717 effective March 1, 2026. Claims for J0717 with ulcerative colitis diagnosis will be denied after this date.
Action Required
By March 1, 2026: Billing team must update system to flag J0717 claims with ulcerative colitis diagnoses for Texas Medicaid patients. Stop billing J0717 for ulcerative colitis treatment under Texas Medicaid - claims will be denied. Providers should identify alternative covered medications or seek prior authorization through patient's specific MCO.