MedicaidBilling CodesMedium impact
TMPPM Update for HTW and Microbiology Procedure Code G0433
Texas Medicaid·TX · OB-GYN·Coding
Effective date
Apr 1, 2026
We identified it
Jan 31, 2026
Summary
Beginning April 1, 2026, Texas Medicaid will deny claims for procedure code G0433 if billed on the same date of service as procedure code 86703 by any provider. This affects both the Healthy Texas Women Program and microbiology services.
Action Required
Before April 1, 2026: Billing team must update system edits to prevent billing G0433 and 86703 on the same date of service. Add claim validation rules to flag these combinations before submission. Update encounter forms and provider documentation to alert staff of this restriction. Claims violating this rule will be automatically denied by Texas Medicaid.