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Reimbursement Rate Changes and Updates for Texas Medicaid Procedure Codes Effective October 1, 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.

Effective for dates of service on or after October 1, 2024, reimbursement rate changes and updates for procedure codes that were presented at a public rate hearing on May 21, 2024, will be implemented for Texas Medicaid.

The public rate hearing covered the Calendar Fee Review for the following:

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