Date: October 2, 2025
Attention: Prescribers
Effective date: October 1, 2025
Call to action: Effective for dates of service on or after October 1, 2025, Texas Medicaid will update the diagnosis code requirements for hematopoietic injection procedure codes.
How this impacts providers: Diagnosis Code Changes to Procedure Codes J0881, J0885, and J0888
| Procedure Code | Diagnosis Code Added | Diagnosis Codes Removed |
| J0881 | D464 | N185, N186 |
| J0885 | I120 | N185, N186 |
| J0888 | n/a | I120, I1311, I132, N185, N186 |
Resource: Texas Medicaid Provider Procedures Manual (TMPPM), Outpatient Drug Services Handbook, subsection 6.59, “Hematopoietic Injections,” for a list of additional allowed diagnosis codes.
Additionally, Procedure Codes J0882 and Q4081 to Be Removed From Outpatient Drug Services Handbook.
On October 1, 2025, TMHP will also update the TMPPM to remove procedure codes J0882 and Q4081 from the Outpatient Drug Services Handbook.
Providers can refer to the current TMPPM, Clinics and Other Outpatient Facility Services Handbook, subsection 6.2.2, “Renal Dialysis Facilities—Consolidated Billing,” for benefit information about procedure codes J0882 and Q4081.
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.
