Skip to main content

Reimbursement Rate Updates for Procedure Codes Presented at the July 20, 2022, Public Rate Hearing

Last updated on

Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, precertification, 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, January 1, 2022, July 1, 2022, and September 1, 2022, reimbursement rate updates for procedure codes that were presented at a public rate hearing on July 20, 2022, will be implemented.

Effective for Dates of Service on or After January 1, 2021

Effective for Dates of Service on or After January 1, 2022

Effective for Dates of Service on or After July 1, 2022

Effective for Dates of Service on or After September 1, 2022

Any affected claims that are identified will be reprocessed. Providers are not required to appeal the claims unless the claims are denied for additional reasons after reprocessing is completed.

More Information

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