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Iron Injection Age Limitations to Be Updated for Texas Medicaid
Date: January 8, 2026
Attention: Providers
Effective date: February 1, 2026
Call to action: Texas Children’s Health Plan (TCHP) would like to make providers aware that on February 1, 2026, the Texas Medicaid & Healthcare Partnership (TMHP) will update the “Iron Injections” section of the Texas Medicaid Provider Procedures Manual (TMPPM), Outpatient Drug Services Handbook to replace the treatment indications with the client age requirements that are listed in the table below.
How this impacts providers: Texas Medicaid will limit reimbursement of claims for iron injections to clients who meet the following age requirements:
| Iron Injection | Client Age Requirement |
| Ferric derisomaltose (procedure code J1437) | 18 years of age or older |
| Ferric carboxymaltose (procedure code J1439) | 1 year of age or older |
| Iron dextran (procedure code J1750) | 4 months of age or older |
| Iron sucrose (procedure code J1756) | 2 years of age or older |
| Sodium ferric gluconate complex (procedure code J2916) | 6 years of age or older |
| Ferumoxytol (procedure code Q0138) | 18 years of age or older |
Next step for Providers: Providers should share this communication with their billing staff.
If you have any questions, please email Provider Relations at providerrelations@texaschildrens.org.
For access to all provider alerts www.texaschildrenshealthplan.org/provideralerts.