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MedicaidPrior AuthMedium impact

DME Procedure Codes E1033 and E1034 Now Benefits of the CSHCN Services Program

Texas Medicaid·TX · PM&R (Physical Medicine & Rehab), Pediatrics, Neurology·General
Effective date
Apr 1, 2025
We identified it
Feb 28, 2026
Days to comply

Summary

DME wheelchair parts procedure codes E1033 and E1034 are now covered benefits under the CSHCN Services Program effective April 1, 2025, with a reimbursement rate of $148.98 each. Prior authorization is mandatory for these codes - claims will be denied without it.

Action Required

Action needed
Before April 1, 2025: Billing team must update system to require prior authorization for codes E1033 and E1034 under CSHCN Services Program. Submit CSHCN Prior Authorization form with medical necessity documentation. Claims will not be reimbursed without prior authorization. Contact TMHP-CSHCN at 800-568-2413 for questions.

Affected Billing Codes

E1033
E1034