Date: July 14, 2025
Attention: All Providers
Effective date: October 1, 2024
Call to action: The purpose of this communication is to inform providers that effective for dates of service on or after October 1, 2024, the Texas Medicaid & Healthcare Partnership (TMHP) will implement reimbursement rate updates for certain third quarter 2024 Healthcare Common Procedure Coding System (HCPCS) non-drug procedure codes for Texas Medicaid.
TMHP will reprocess any affected claims that are identified. After the reprocessing is complete, providers will not need to appeal the claims unless TMHP has denied them for additional reasons. To view the updates, access the Third Quarter 2024 HCPCS Non-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.