MedicaidReimbursementMedium impact
Reimbursement Rate Updates for Syphilis Testing Procedure Code 86593 Effective May 1, 2025, for FPP
Texas Medicaid·TX · Family Medicine, OB-GYN, Internal Medicine +1 more·Billing
Effective date
May 1, 2025
We identified it
Jan 27, 2026
Summary
Texas Medicaid is updating reimbursement rates for syphilis testing procedure code 86593 under the Family Planning Program, effective May 1, 2025. TMHP will automatically reprocess affected claims and adjustments will appear on future Remittance and Status Reports.
Action Required
Before May 1, 2025: Billing team should review the FPP Syphilis Testing procedure code spreadsheet for updated reimbursement rates for CPT 86593. Monitor future Remittance and Status Reports for automatic claim reprocessing adjustments. Contact TMHP at 800-925-9126 if questions arise about claim reprocessing.