Texas Medicaid (TMHP) Adds Prior-Authorization Rules to Healthy Texas Women, Effective July 1, 2026, New Billing Burden for FQHC Family-Planning Clinics
Issue
On May 15, 2026, the Texas Medicaid & Healthcare Partnership (TMHP) published a bulletin requiring new prior authorizations for Healthy Texas Women (HTW) and HTW Plus services effective July 1, 2026, including MRI imaging and certain clinician-administered drugs (CADs). Several CAD codes (J0695, J1551, J1611, J1729, J2402) are removed as HTW benefits while new codes are added — a direct change to billing workflows at Texas FQHCs and family-planning clinics that serve HTW enrollees.
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FQHC Talent. (2026, May 15). Texas Medicaid (TMHP) Adds Prior-Authorization Rules to Healthy Texas Women, Effective July 1, 2026, New Billing Burden for FQHC Family-Planning Clinics. Source: Texas Medicaid & Healthcare Partnership (TMHP). Retrieved October 6, 2026, from https://www.fqhctalent.com/intel/tx-tmhp-htw-prior-auth-cad-changes-july-2026
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