Date: January 26, 2026
Attention: Providers
Effective for dates of service on or after: 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 August 13, 2025, and it contained incorrect information in the Dialysis Services spreadsheet. The original article featured incorrect information in the “Cardiovascular Services, including Cardiography & Echocardiography - Rural Hospital” spreadsheet. The affected spreadsheet has been updated and now features the correct reimbursement information.
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.
The following topics were covered during the May 2025 public rate hearing:
Calendar Fee Review for the following:
Third Quarter 2025 Healthcare Common Procedure Coding System (HCPCS) Review for the following:
Fourth Quarter 2025 HCPCS Review for the following:
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 step for Providers: 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.
