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Reimbursement Rate Updates for MTP and IHS Procedure Codes Effective January 1, 2025

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Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO. Administrative procedures, such as prior authorization, precertification, referrals, and claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the member’s specific MCO for details.

Effective for dates of service on or after January 1, 2025, reimbursement rate updates for Medical Transportation Program (MTP) and Indian Health Service (IHS) procedure codes that were presented at the public rate hearing on February 14, 2025, will be implemented.

The Texas Medicaid & Healthcare Partnership (TMHP) will reprocess any affected claims that are identified. Providers are not required to appeal the claims unless they are denied for additional reasons after reprocessing is completed.

To view the updates, access the following spreadsheets:

For more information, call the TMHP Contact Center at 800-925-9126.