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Off-Cycle Static Fee Schedule to Be Displayed on June 16, 2025

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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.

The Texas Medicaid & Healthcare Partnership (TMHP) has identified an issue with the static fee schedule update that ran on April 15, 2025. The Clinical Laboratory static fee schedule (PRCR494C) included in the update had duplicate rows. TMHP has resolved the issue and will publish an off-cycle static fee schedule on June 16, 2025, which will include the corrected Clinical Laboratory static fee schedule.

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