Flu Season Alert!Alerta de temporada de influenza:
Don’t let germs win this season – protect yourself and your family!
The flu vaccine is your best defense against flu and related complications – PLUS, it is a covered benefit for Texas Children’s Health Plan members! Learn more!
¡No permitas que los gérmenes ganen esta temporada! ¡Protégete a ti y a tu familia!
La vacuna contra la influenza es tu mejor defensa contra la influenza y sus complicaciones. Además, ¡es un beneficio cubierto para los miembros de Texas Children's Health Plan! Aprende más
Correction to Reimbursement Rate Changes and Updates for Certain Texas Medicaid Procedure Codes
Date: August 21, 2025
Attention: Providers
Effective date: September 1, 2025
Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers of an important update to a provider alert published. The original TMHP Bulletin was published on July 24, 2025 and it contained incorrect information in the Dialysis Services spreadsheet. The affected spreadsheet has been updated and now features the correct reimbursement information. Here is the link to the correct spreadsheet, Dialysis Services.
How this impacts providers: Effective for dates of service on or after September 1, 2025, the Texas Medicaid & Healthcare Partnership (TMHP) will implement the reimbursement rate changes and updates for the procedure codes that were presented at the public rate hearing on May 27, 2025.
Texas Medicaid managed care organizations (MCOs) like TCHP must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO/TCHP. Administrative procedures, such as prior authorization, precertification, referrals, and claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should reference a member’s specific MCO/TCHP for information on these items. For TCHP, this information can be found on the provider page available here https://www.texaschildrenshealthplan.org/providers
Next step for Providers: Providers should share this communication with their staff.
