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Update to “First Quarter 2025 HCPCS Updates for Texas Medicaid”

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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.

This is an update to the article titled “First Quarter 2025 HCPCS Updates for Texas Medicaid,” which was published on this website on March 31, 2025.

The article stated that the client age limitation for procedure code J9054 is birth through 24 months of age.

The client age limitation for procedure code J9054 has been updated to 18 years of age or older.

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