Additional Provider Types Added for Encelto Procedure Code J3403
Date: January 22, 2026
Attention: All Providers
Effective date: February 1, 2026
Call to action: Texas Children’s Health Plan (TCHP) informs providers that effective for dates of service on or after February 1, 2026, the Texas Medicaid & Healthcare Partnership (TMHP) will consider claims for revakinagene-taroretcel-iwey (Encelto) (procedure code J3403) for reimbursement when providers at free-standing, independent, or hospital ambulatory surgical centers render services in the outpatient hospital setting.
Next steps: Providers should share this communication 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.