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Procedure Code J2804 No Longer a Tuberculosis Clinic Benefit Effective December 1, 2025

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Effective for dates of service on or after December 1, 2025, procedure code J2804 will no longer be a benefit of Texas Medicaid when tuberculosis clinics provide the service. This change aligns Texas Medicaid with the U.S. Centers for Disease Control and Prevention (CDC) recommendation for oral medication treatments for tuberculosis in outpatient clinics.

Providers may refer to the current Texas Medicaid Provider Procedures Manual (TMPPM), Clinics and Other Outpatient Facility Services Handbook, section 9, “Tuberculosis Services,” for additional information about tuberculosis service benefits.

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.