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Reimbursement Rate Updates for MTP Procedure Code S0215 Effective January 1, 2026

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Effective for dates of service on or after January 1, 2026, Texas Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program will implement reimbursement rate changes and updates for Medical Transportation Program (MTP) procedure code S0215.

To view the updates, access the Medical Transportation Program Procedure Code spreadsheet.

Claims Reprocessing

Texas Medicaid & Healthcare Partnership (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 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.

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.