July 4th Holiday Horario de 4 de julio

Texas Children's Health Plan will be closed on Friday, July 4th, in observance of Independence Day. In our absence, you can reach our after-hours nurse help line at 1-800-686-3831. We will resume normal business hours on Monday, July 7th. Wishing you a safe and happy Independence Day!

Texas Children's Health Plan estará cerrado el viernes 4 de julio por el Día de la Independencia. Durante este tiempo, puede comunicarse con nuestra línea de ayuda disponible las 24 horas, los 7 días de la semana, al 1-800-686-3831. Reanudaremos nuestro horario habitual el lunes 7 de julio. ¡Le deseamos un feliz y seguro el Día de la Independencia!

Cold and flu season Temporada de influenza y resfriados

ALERT: Stay healthy this cold and flu season! Learn more

ALERTA: ¡Mantente sano durante esta temporada de influenza y resfriados! Más información

Search

Reimbursement Rate Updates for Certain HCPCS Drug Procedure Codes

Date: July 7, 2025

Attention: All Providers

Effective date: April 1, 2025

Call to action: The purpose of this communication is to inform providers that effective for dates of service on or after April 1, 2025, the Texas Medicaid & Healthcare Partnership (TMHP) will change the reimbursement rates for certain Healthcare Common Procedure Coding System (HCPCS) drug procedure codes that were updated during the first quarter of 2025. These rate updates will be implemented for Texas Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program.

TMHP will reprocess any affected claims that are identified. Providers can appeal the claims if TMHP denies them for additional reasons after reprocessing is completed.

To view the updates, access the Drug Procedure Codes spreadsheet.

Next steps: Providers should share this communication with their staff. 

If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org. 

For access to all provider alerts:
www.texaschildrenshealthplan.org/provideralerts.