Date: August 14, 2026
Attention: Providers
Effective date: January 1, 2026
Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that effective for dates of service on or after January 1, 2026, Texas Medicaid will implement reimbursement rate changes and updates for the Medical Transportation Program (MTP) and Indian health services procedure codes that were presented at the public rate hearing on May 26, 2026.
To view the updates, access the following spreadsheets:
How this impacts providers: Claims Reprocessing
Texas Medicaid & Healthcare Partnership (TMHP) will identify and reprocess any claims that have been affected by this update. If there are any adjustments to claims reimbursement amounts, they will appear on future Remittance and Status (R&S) Reports.
Next step for Providers: Providers should share this communication with their staff.
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, 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 texaschildrenshealthplan.org/providers.
If you have any questions, please email Provider Relations at providerrelations@texaschildrens.org.
For access to all provider alerts www.texaschildrenshealthplan.org/provideralerts.
