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Reimbursement Rate Updates for Certain Annual HCPCS Procedure Codes Effective January 1, 2024, and January 2, 2024

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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.

Reimbursement rate updates for certain Annual 2024 Healthcare Common Procedure Coding System (HCPCS) drug procedure codes have been implemented for Texas Medicaid. Some of these updates are effective for dates of service on or after January 1, 2024, and some are effective for dates of service on or after January 2, 2024. To view the updates, see the following spreadsheets:

To view the updates, see the following spreadsheets:

Effective January 1, 2024

Effective January 2, 2024

The Texas Medicaid & Healthcare Partnership (TMHP) will reprocess any affected claims that are identified. Providers are not required to appeal the claims unless the claims are denied for additional reasons after reprocessing is completed.

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