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New Static Fee Schedule for National Drug Codes Coming December 19, 2025

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On December 19, 2025, the Texas Medicaid & Healthcare Partnership (TMHP) will publish a new static fee schedule that will list the high-cost clinician-administered drug (HCCAD) Skysona (procedure code J3590). The new fee schedule will be available on the Static Fee Schedules page and will be titled “National Drug Codes.” TMHP may list additional HCCAD fees in the fee schedule in the future.

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

Important: 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.