Date: December 1, 2025
Attention: All Providers
Effective date: January 1, 2026
Call to action: Texas Children’s Health Plan (TCHP) informs providers that on January 1, 2026, the Texas Medicaid & Healthcare Partnership (TMHP) will update language in the following sections of the Texas Medicaid Provider Procedures Manual (TMPPM), Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook:
- “Hospital Beds and Equipment”
- “Hospital Beds”
- “Pediatric Hospital Beds and Safety Enclosure”
Hospital Beds and Equipment
In the “Hospital Beds and Equipment” section, the updated language will include the following:
A standard bed that is typically sold as furniture may consist of a frame, box spring, and mattress, is of fixed height, and has no head or leg elevation adjustments. These types of beds are not:
- Primarily medical in nature.
- Made with materials that withstand frequent cleaning and disinfecting.
- Primarily used in the treatment of disease or injury.
- Considered durable medical equipment (DME) by Texas Medicaid.
Hospital Beds
In the “Hospital Beds” section, the updated language will include the following:
Beds that are primarily used for the purpose of safety are not a benefit of Texas Medicaid. These beds do not meet the definition of DME as described by 42 CFR § 414.202.
A hospital bed is defined as a medical device with all of the following features:
- An articulating frame, which allows adjustment of the head and foot of the bed for the purpose of repositioning
- A headboard
- A foot board
- A mattress
- Side rails of any type (A side rail is defined as a hinged or removable rail, board, or panel of any height.)
Pediatric Hospital Beds and Safety Enclosure
In the “Pediatric Hospital Beds and Safety Enclosure” section, the following statement will be added:
A safety enclosure (procedure code E0316) is an accessory that is used in conjunction with a pediatric hospital bed or crib.
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.
