Reimbursement Rate Updates for Procedure Code T1015

Date: March 30, 2026

Attention: Providers

Effective date: January 1, 2026

Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that effective for dates of service on or after January 1, 2026, Texas Medicaid will implement reimbursement rate changes and updates for Indian Health Services procedure code T1015.

How this impacts providers: To view the updates, access the Indian Health Services Procedure Code.

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

Next step for Providers: Providers should share this information with their staff. Texas Medicaid managed care organizations (MCOs) like Texas Children’s Health Plan (TCHP) must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO/TCHP. Administrative procedures, such as prior authorization, precertification, referrals, claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should reference a member’s specific MCO/TCHP for information on these items. For TCHP, this information can be found on the provider page available at https://www.texaschildrenshealthplan.org/providers.

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

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