September 2026 TMPPM Update for Hearing Aid Services
Date: August 14, 2026
Attention: All Providers
Effective date: September 1, 2026
Call to action: Texas Children's Health Plan (TCHP) would like to inform providers that effective September 1, 2026, the Texas Medicaid & Healthcare Partnership (TMHP) will update the “Hearing Aid Services” section of the Texas Medicaid Provider Procedures Manual (TMPPM), Vision and Hearing Services Handbook, to include current limitations and claims filing requirements.
The update is in line with information in the article titled “Limitations and Claim Filing Requirements for New Hearing Device Procedure Codes,” which was published on tmhp.com on March 9, 2026.
Additional Updates
The following limitations will be updated to specify that they only apply when services are performed on the same ear:
- TMHP will deny claims for procedure code 92628 when they are submitted by any provider on the same date of service, for the same ear, as one of the following procedure codes: 92622, 92623, 92626, 92627, 92634, 92635, 92636, 92637, or V5010.
- TMHP will deny claims for procedure code 92631 when they are submitted by any provider on the same date of service, for the same ear, as one of the following procedure codes: 92622, 92623, 92626, 92627, 92636, or 92637.
Next step for providers: Providers should share this information 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.