HCPCS Annual Updates for 2026

Call to action: The purpose of this communication is to inform providers that on January 1, 2026, the Texas Medicaid & Healthcare Partnership (TMHP) applied the 2026 Healthcare Common Procedure Coding System (HCPCS) additions, revisions, and discontinuations.

2026 HCPCS Procedure Code Additions

How this impacts providers: Important details about the updates are as follows.

• Benefit changes related to the 2026 annual HCPCS updates will be published in a special bulletin by February 1, 2026.
• Discontinued procedure codes will no longer be benefits of Texas Medicaid or the Children with Special Health Care Needs (CSHCN) Services Program.
• The presence of “Requires rate hearing” or “Requires rate review” in the 2026 HCPCS Procedure Code Additions table indicates a new procedure code that is pending a rate hearing and approval of expenditures.
• Providers will be notified in a future article if a new procedure code is not approved for reimbursement.

Providers may refer to the following resources for more information about the public rate hearings and approval of expenditure:

• https://pfd.hhs.texas.gov/rate-packets
• https://sos.state.tx.us/texreg/index.shtml

Next step for Providers: Providers should share this communication with their staff. 
Important: To avoid submitting fraudulent claims, providers must submit claims with the procedure codes that are most appropriate for the services that are provided.

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

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