Procedure Code S5552 to Be Removed From TMPPM Healthy Texas Women Program Handbook

Date: June 24, 2025

Attention: Primary Care and Obstetric Care Providers

Texas Medicaid Provider Procedures Manual update: August 1, 2025

Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that Texas Medicaid & Healthcare Partnership (TMHP) will remove procedure code S5552 from the supplies and services and diabetes services procedure code tables. Providers can use procedure code J1815 instead of procedure code S5552.

How this impacts providers: On August 1, 2025, the Texas Medicaid & Healthcare Partnership (TMHP) will update the Texas Medicaid Provider Procedures Manual (TMPPM), Healthy Texas Women Program Handbook, section 2.3, “Services, Benefits, Limitations, and Prior Authorization,” and section 2.3.11, “HTW Plus Services, Benefits, and Limitations.”

Next step for Providers: Providers should share this communication with their billing staff.

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

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