MedicaidCoverageMedium impact
April 2026 TMPPM Update for Stereotactic Radiosurgery
Texas Medicaid·TX · Oncology, Radiology·General
Effective date
Apr 1, 2026
We identified it
Feb 14, 2026
Summary
Effective April 1, 2026, Texas Medicaid will cover stereotactic radiosurgery and proton beam radiation therapy for pediatric cancers in patients 20 years and younger, with prior authorization required. This expands coverage for these specialized cancer treatments to include children.
Action Required
By April 1, 2026: Billing team must update prior authorization workflows to include pediatric cancer patients (age 20 and younger) as eligible for stereotactic radiosurgery and proton beam radiation therapy codes 77520, 77522, 77523, 77525, and S8030. Contact patient's specific MCO for prior authorization requirements as procedures may vary between managed care organizations.