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Reimbursement Rate Updates for Procedure Code J2787 Presented at the August 4, 2025, Public Rate Hearing

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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 September 1, 2025, the Texas Medicaid & Healthcare Partnership (TMHP) will implement the reimbursement rate updates for procedure code J2787 that were presented at the public rate hearing on August 4, 2025.

The Medical Policy Review of Physician Administered Drug Procedure Code J2787 was covered at the hearing.

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