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Reimbursement Rate Changes and Updates for Texas Medicaid Procedure Codes Effective January 1, 2021 and September 1, 2021

Last updated on 8/13/2021

This notification has been corrected. For the corrected information, click here.

Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details.

Effective for dates of service on or after January 1, 2021, and September 1, 2021, reimbursement rate changes and updates for procedure codes presented at a public rate hearing on May 25, 2021, will be implemented.

The following topics were covered at the public rate hearing:

Effective for dates of services on or after January 1, 2021

Effective for dates of services on or after September 1, 2021

 For more information:

  • Refer to the Health and Human Services (HHS) Rate Analysis web page at hhs.texas.gov/rate-packets.
  • Call the TMHP Contact Center at 800-925-9126.