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Reimbursement Rate Updates for Certain CSHCN HCPCS Drug Procedure Codes Effective April 1, 2026

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The Texas Medicaid & Healthcare Partnership (TMHP) has revised the reimbursement rates for Healthcare Common Procedure Coding System (HCPCS) drug procedure codes that were updated during the first quarter of 2026 for the Children with Special Health Care Needs (CSHCN) Services Program.

Providers can view the updates in the Drug Procedure Codes spreadsheet.

Claims Reprocessing

TMHP will identify and reprocess any claims that have been affected by this update. If there are any adjustments to claims reimbursement amounts, they will appear on future Remittance and Status (R&S) Reports.

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