FQHC And RHC Reimbursement For CoCM Services: What Providers Need To Know
During the 2026 annual HCPCS code update, CMS removed procedure code G0512, which FQHCs and RHCs previously used for Collaborative Care Model services. This change became effective on January 01, 2026.
Starting June 01, 2026, Texas Medicaid will allow FQHC and RHC providers to use CoCM procedure codes 99492, 99493, 99494, and G2214 for claims with dates of service on or after January 01, 2026.
Texas Medicaid may pay these CoCM codes separately from the regular FQHC or RHC encounter rate. This means eligible providers may receive reimbursement for these services in addition to their standard encounter payment.
TMHP will also review claims submitted by FQHC and RHC providers before June 1, 2026, that were affected by this code change. If a claim needs to be adjusted, the updated payment details will appear on a future remittance and status report.
For questions, providers can contact the TMHP Contact Center at 800-925-9126.
Note: Providers working with Texas Medicaid managed care members should also check with the member’s specific MCO. Each MCO may have its own rules for prior authorization, referrals, precertification, claims, and encounter data submission.
