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Photrexa Is Now a Benefit of Texas Medicaid

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On September 1, 2025, Photrexa (procedure code J2787) became a benefit of Texas Medicaid for clients of all ages. Providers must submit claims for procedure code J2787 with one of the following provider types, the appropriate place of service for the provider type, and a date of service on or after September 1, 2025.

Provider TypePlace of Service
Physician, physician assistant, nurse practitioner, clinical nurse specialistOffice
Hospital, Rural emergency hospitalOutpatient hospital

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

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.