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Iron Injection Age Limitations to Be Updated for Texas Medicaid

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Effective for dates of service on or after February 1, 2026, Texas Medicaid will limit reimbursement of claims for iron injections to clients who meet the following age requirements:

Iron InjectionClient Age Requirement
Ferric derisomaltose (procedure code J1437)18 years of age or older
Ferric carboxymaltose (procedure code J1439)1 year of age or older
Iron dextran (procedure code J1750)4 months of age or older
Iron sucrose (procedure code J1756)2 years of age or older
Sodium ferric gluconate complex (procedure code J2916)6 years of age or older
Ferumoxytol (procedure code Q0138)18 years of age or older

On February 1, 2026, the Texas Medicaid & Healthcare Partnership (TMHP) will update the “Iron Injections” section of the Texas Medicaid Provider Procedures Manual (TMPPM), Outpatient Drug Services Handbook to replace the treatment indications with the client age requirements that are listed in the table above.

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.