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DME Procedure Codes E1033 and E1034 Now Benefits of the CSHCN Services Program

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Effective February 25, 2026, for dates of service on or after April 1, 2025, durable medical equipment (DME) procedure codes E1033 and E1034 are benefits of the Children with Special Health Care Needs (CSHCN) Services Program.

The reimbursement rate for each procedure code is $148.98.

Prior Authorization Requirements

To request prior authorization of DME wheelchair parts procedure codes E1033 and E1034, CSHCN Services Program providers must submit the CSHCN Services Program Prior Authorization and Authorization Request for Durable Medical Equipment (DME) Form and Instructions. They must also submit documentation of medical necessity.

Important: The Texas Medicaid & Healthcare Partnership (TMHP) will not reimburse claims for procedure codes E1033 and E1034 without prior authorization.

TMHP will identify and reprocess any affected claims with dates of service on or after April 1, 2025. Providers do not need to appeal the claims unless the claims are denied for additional reasons after reprocessing is completed.

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