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Important Update Actualización importante:

Good news! All CHIP, STAR, and STAR Kids Member Handbooks are now available online. Quick, easy access to your benefits and coverage information - any time!

¡Buenas noticias! Todos los manuales para miembros de CHIP, STAR y STAR Kids ya están disponibles en línea. Obtén acceso rápido y sencillo a la información sobre tus beneficios y cobertura, ¡en cualquier momento!

Iron Injection Age Limitations to Be Updated for Texas Medicaid

Date: January 8, 2026

Attention: Providers

Effective date: February 1, 2026

Call to action: Texas Children’s Health Plan (TCHP) would like to make providers aware that on February 1, 2026, the Texas Medicaid & Healthcare Partnership (TMHP) will update the “Iron Injections” section of the Texas Medicaid Provider Procedures Manual (TMPPM), Outpatient Drug Services Handbook to replace the treatment indications with the client age requirements that are listed in the table below.

How this impacts providers: Texas Medicaid will limit reimbursement of claims for iron injections to clients who meet the following age requirements:

Iron InjectionClient Age Requirement
Ferric derisomaltose (procedure code J1437)18 years of age or older
Ferric carboxymaltose (procedure code J1439)1 year of age or older
Iron dextran (procedure code J1750)4 months of age or older
Iron sucrose (procedure code J1756)2 years of age or older
Sodium ferric gluconate complex (procedure code J2916)6 years of age or older
Ferumoxytol (procedure code Q0138)18 years of age or older

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.