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Reimbursement Updates for Dental Rate Reallocation and Medical Surgical Supplies Procedure Codes

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Updated reimbursement rates for medical and surgical supplies and dental rate reallocation procedure codes were presented at public rate hearings on May 27, 2025, and July 22, 2025, respectively, and approved by the Health and Human Services Commission.

On September 1, 2025, the Texas Medicaid & Healthcare Partnership (TMHP) implemented the new rates for dates of service on or after September 1, 2025.

Providers can view the updates in the following spreadsheets:

Claims Reprocessing

TMHP will identify and reprocess any claims that have been affected by this update. If there are any adjustments to claims reimbursement amounts, they will appear on future Remittance and Status (R&S) Reports.

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

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.