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Update to TMPPM and the CSHCN Services Program Provider Manual for Texas Health Steps and CSHCN Dental Anesthesia Services

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On April 1, 2026, the Texas Medicaid & Healthcare Partnership (TMHP) will update the Texas Medicaid Provider Procedures Manual (TMPPM), Children’s Services Handbook, section 3.2.22, “Adjunctive General Services,” and the Children with Special Health Care Needs (CSHCN) Services Program Provider Manual, Chapter 14, “Dental,” subsection 14.2.6.9, “Adjunctive General Services,” to add the following limitation:

Procedure codes D9210, D9211, D9212, and D9230 are limited to one per day, same procedure, same place of service, by the same provider on the same claim.

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.

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.