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Reimbursement Rate Updates for Certain CSHCN HCPCS Drug Procedure Codes Effective April 1, 2024

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Effective for dates of service on or after April 1, 2024, reimbursement rate updates for certain First Quarter 2024 Healthcare Common Procedure Coding System (HCPCS) drug procedure codes will be implemented for the Children with Special Health Care Needs (CSHCN) Services Program.

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

To view the updates, see the Drugs spreadsheet.

For more information, call the CSHCN Contact Center at 800-568-2413.