Reimbursement Rate Updates for Syphilis Testing Procedure Code 86593

Date: February 2, 2026

Attention: Family Planning Program (FPP) Providers

Effective date: May 1, 2025

Call to action: Texas Children’s Health Plan (TCHP) informs providers effective for dates of service on or after May 1, 2025, the Texas Medicaid & Healthcare Partnership (TMHP) will implement the reimbursement rate changes for state-funded Family Planning Program (FPP) syphilis testing procedure code 86593 that were presented at the public rate hearing on November 10, 2025.

Providers can view the updates in the FPP Syphilis Testing procedure code spreadsheet.

Claims Reprocessing

TMHP will identify and reprocess any claims that have been affected by this update. Any adjustments to claims reimbursement amounts will appear on future Remittance and Status (R&S) Reports.

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.