MedicaidBilling CodesMedium impact
Limitation Update to the CSHCN Services Program Provider Manual for Immune Globulins
Texas Medicaid·TX · Allergy & Immunology, Pediatrics, Hematology +2 more·General
Effective date
Apr 1, 2026
We identified it
Jan 31, 2026
Summary
Starting April 1, 2026, Texas Medicaid's CSHCN Services Program will only reimburse one of the three immune globulin procedure codes (J1571, J1573, or 90371) when billed on the same date of service by any provider. This prevents duplicate billing for immune globulin treatments.
Action Required
By April 1, 2026: Billing team must update system to flag and prevent billing multiple immune globulin codes (J1571, J1573, 90371) on the same date of service for CSHCN patients. Update billing edits to allow only one code per date. Train staff that only one immune globulin code will be reimbursed per day regardless of provider.