Procedure Code 86593 To Become a Payable Benefit for HHSC Family Planning Program (FPP) Services

Date: July 24, 2025

Attention: Providers

Effective date: July 31,2025

Call to action: Texas Children’s Health Plan (TCHP) would like to make providers aware that effective July 31, 2025, laboratory service procedure code 86593 will be added as a payable benefit for Texas Health and Human Services Commission (HHSC) Family Planning Program (FPP) services for dates of service on or after May 1, 2025.

How this impacts providers: This benefit will be available to clients of all ages when services are provided in the office setting.

Claims information: The Texas Medicaid & Healthcare Partnership (TMHP) will reprocess any affected claims with dates of service from May 1, 2025, through July 31, 2025. If applicable, TMHP will issue additional payments, which will be reflected on future Remittance and Status (R&S) Reports.

Next step for Providers: 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.