Skip to main content

Reimbursement Rate Updates for Certain 2024 Third Quarter HCPCS Non-Drug Procedure Codes Effective October 1, 2024

Last updated on

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, the Texas Medicaid & Healthcare Partnership (TMHP) will implement reimbursement rate updates for certain third quarter 2024 Healthcare Common Procedure Coding System (HCPCS) non-drug procedure codes for Texas Medicaid.

TMHP will reprocess any affected claims that are identified. After the reprocessing is complete, providers will not need to appeal the claims unless TMHP has denied them for additional reasons.

To view the updates, access the Third Quarter 2024 HCPCS Non-Drug Procedure Codes spreadsheet.

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