Updated 2026 ICD-10-PCS Procedure Codes Effective April 1, 2026

Date: March 31, 2026

Attention: All Providers

Call to action: Texas Children’s Health Plan would like to inform providers that on April 1, 2026, the Texas Medicaid & Healthcare Partnership (TMHP) will implement surgical procedure code additions, discontinuations, and revisions based on updates that were made to 2026 International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS). The ICD-10-PCS codes are inpatient hospital procedure codes that providers must only submit, as applicable, on inpatient hospital claims.

Note: For professional and outpatient procedures and services, providers must continue to use the American Medical Association (AMA) Current Procedural Terminology (CPT) Manual and the Centers for Medicare and Medicaid (CMS) Healthcare Common Procedure Coding System (HCPCS) Manual.

ICD-10-PCS Procedure Codes

Providers should refer to the appropriate copyright holder’s code listing for descriptions of the new, discontinued, and revised procedure codes indicated below. Texas Medicaid will not reimburse claims for the discontinued procedure codes for dates of service on or after April 1, 2026.

Note: These procedure codes are surgical codes used to assign the proper diagnosis-related group (DRG) for an inpatient hospital stay and are processed as informational only.

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.