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TMPPM Update for HTW and Microbiology Procedure Code G0433

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On April 1, 2026, the Texas Medicaid & Healthcare Partnership (TMHP) will update the Texas Medicaid Provider Procedures Manual (TMPPM), Healthy Texas Women Program Handbook, section 2.3, “Services, Benefits, Limitations, and Prior Authorization,” and the Radiology and Laboratory Services Handbook, section 2.11, “Microbiology,” to update the limitation for procedure code G0433.

The updated limitation is as follows:

Claims for procedure code G0433 will be denied if they are billed on the same date of service by any provider as procedure code 86703.

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.