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Coming October 2025: Third Quarter HCPCS Updates to CSHCN Services Program Procedure Codes

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On October 1, 2025, the Texas Medicaid & Healthcare Partnership (TMHP) will implement procedure code additions, revisions, and discontinuations based on updates that were made to the Healthcare Common Procedure Coding System (HCPCS) by the Centers for Medicare & Medicaid Services (CMS) for the third quarter of 2025. The updates will be effective for dates of service on or after October 1, 2025.

Discontinued procedure codes will no longer be benefits of the Children with Special Health Care Needs (CSHCN) Services Program.

Added procedure codes will not be reimbursed until the Texas Health and Human Services Commission (HHSC) reviews the codes and holds a rate hearing. Providers will be notified of any benefit changes in a future article. Providers can refer to the CSHCN Services Program Provider Manual for current benefit information.

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