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Texas DSHS Lab Fee Schedule Updates 2026: Test Additions, Deletions, and Fee Changes

August 21, 2026

Texas DSHS is rolling out its 2026 fee schedule on September 1, and this year’s changes are anything but minor. The Austin lab is dropping AFB probe and Rubella IgG testing while adding a new metals-in-food panel. Down in South Texas, the changes hit harder—lipid panels are jumping from $10 to nearly $32, hepatic function panels are tripling, and routine chemistries like ALT, BUN, and glucose are seeing significant bumps. Meanwhile, lipase and renal function panels are actually dropping.

Four tests are being retired across both locations: AFB probe, Rubella IgG, T3 uptake, and urine microalbumin. Billers need to inactivate those codes before September 1, or claims will bounce back. The smart move? Pull the official spreadsheet, map every change into your billing system, and run a small test batch on September 1 to catch any mismatches.

Every year, the Texas Department of State Health Services refreshes its laboratory fee schedule, and 2026 is no different. To prevent claim denials from affecting your revenue, it’s important to understand how DSHS updates work.

If you figure out what gets added, what gets reduced, and how rates tend to shift, you can build a bulletproof update process now. Then, when the official spreadsheet drops, you just plug and play.

Let’s break down exactly how to prepare for the 2026 Texas DSHS lab fee changes so your billing team isn’t scrambling later, and how end-to-end laboratory RCM services help you manage fee schedules.

Get Clean Claim Submissions with Latest CPT Coding Compliance for Your Texas Lab.

What Drives the Texas DSHS Lab Fee Schedule Updates in 2026?

Every DSHS fee schedule revision results from some factors. Knowing them helps you predict the changes.

New CPT and PLA codes: The American Medical Association (AMA) rolls out new lab codes every year, and DSHS typically adopts the ones that align with its testing menu, especially for infectious disease panels and molecular diagnostics.
Public health priorities: When a particular disease gains ground in Texas, such as syphilis and hepatitis are prime examples, DSHS responds by adding or updating relevant testing codes to make screening more accessible.
Reagent and supply costs: Reagent and supply costs don’t stay flat, so you’ll notice fee adjustments that reflect what it actually costs to run the tests; higher supply prices usually mean a bump in reimbursement.
Obsolete or redundant tests: Outdated methods get dropped. Multiplex panels replace single-pathogen tests. Non-reflexive screening algorithms give way to streamlined, bundled codes.

Based on that, the 2026 schedule:

includes new codes for modern test methods
removes codes for tests no longer considered best practice
adjusts fees to stay aligned with operational costs

Where to Find the Official 2026 Texas DSHS Lab Fee Schedule?

The final 2026 fee schedule is available on the Texas DSHS Laboratory Patient Fee Schedule page. The agency usually posts the upcoming year’s spreadsheet in the fall, but always check for revisions through early January.

This year, the DSHS Public Health Laboratory is set to make the changes to the fee schedule effective by September. Fees have been modified for tests. Fees have increased in some tests while reduced in a few instances. Some tests have also been deleted from it.

Changes to the Austin DSHS Lab Fee Schedule in 2026

The Texas DSHS’ main laboratory is located in Austin. Here are a few changes to the Austin fee schedule in 2026.

Discontinued Tests

The following tests are deleted from the Austin DSHS Laboratory’s fee schedule:

Acid-Fast Bacilli (AFB) Isolate Identification; Probe (CPT 87149): The old probe-based identification method is no longer available. DSHS has moved to molecular susceptibility panels for mycobacteria, making this standalone code obsolete.
Rubella IgG (CPT 86762): Austin is directing rubella immunity screening to alternative serological platforms.

If your lab information systems (LIS) still list these codes, they’ll likely be rejected by September. Pull them now.

New Test Addition

A new test has been added to the Austin DSHS lab fee schedule.

Metals in Food, Method EAM 4.7 (As, Cd, Cu, Pb, Se): It helps check which food products contain metals that can be toxic to human health. If your lab serves community health centers or does outbreak work, get this code loaded into your LIS by September 1. The fee for the test is $98.77, starting September 1.

Fee Decreases

On September 1, the fee reimbursement rates are set to be reduced for the following tests:

Test Name	Old Fee (Through 8/31/26)	New Fee (Effective 9/1/26)	CPT Code
Chagas, IgG	$204.00	$197.00	86753
Hemoglobin Electrophoresis	$79.98	$62.72	83020, 83021

According to the fee schedule changes, there is a $7 drop on Chagas testing and a $17.26 cut on hemoglobin electrophoresis. While the difference isn’t much for individual tests, if your lab runs these tests in bulk every month, you can save a great deal.

Changes to the South Texas DSHS Lab Fee Schedule in 2026

The fee schedule changes in the South Texas DSHS laboratory branch are far more impactful than the Austin fee schedule. The Harlingen lab is discontinuing two tests and cutting fees on a handful. At the same time, it’s also increasing the fee for a huge number of routine chemistries and panels.

Tests Retired by DSHS in South Texas Schedule

Texas DSHS has removed these two tests from the South Texas fee schedule. These tests will be discontinued after September 1. These are:

Thyroid Hormone (T3) Uptake (CPT 84479): An older thyroid function assessment that’s largely been replaced by direct free T3 and free T4 measurements.
Urine Microalbumin, Random (CPT 82044): Providers will need to shift to the albumin-to-creatinine ratio panel for kidney disease screening.

A proactive approach is to delete these codes from your LIS. If you submit claims using these codes after September 1, claims are prone to denials.

Fee Decreases in the Schedule

DSHS has reduced the fee for the following tests in the South Texas schedule. The fee changes will be effective from September 1. The table below describes these changes:

Test Name	Old Fee	New Fee	CPT Code
Lactic Acid Dehydrogenase	$9.28	$9.10	83615
Lipase	$23.20	$14.79	83690
Phosphorus	$13.13	$8.04	84100
Renal Function Panel	$20.58	$9.54	80069
Tuberculosis Custom Panel	$11.76	$6.32	Multiple codes

Based on the fee schedule, the rate of lipase has been reduced by about $9, and the TB custom panel fee has been cut by $5. The fee for the renal function panel is cut by more than half.

Fee Increases in the Schedule

South Texas DSHS has raised fees on a massive list of routine tests. The table below breaks down all the fee changes for tests.

Test Name	Old Fee	New Fee	CPT Code
Alanine Amino Transferase (ALT)	$1.52	$8.19	84460
Albumin, serum	$1.44	$7.96	82040
Alkaline phosphatase	$1.56	$8.19	84075
Amylase	$8.37	$12.63	82150
Aspartate aminotransferase (AST)	$1.50	$8.19	84450
Basic Metabolic Panel (BMP)	$4.14	$4.39	80048
Bilirubin, Direct	$1.92	$8.25	82248
Bilirubin, Total	$1.48	$8.03	82247
Bilirubin, Total & Direct Profile	$2.77	$8.25	82247, 82248
Blood Urea Nitrogen (BUN)	$1.68	$8.11	84520
Calcium	$1.86	$8.01	82310
Carbon Dioxide (CO2)	$1.53	$8.74	82374
Chloride, serum	$1.53	$8.63	82435
Cholesterol: HDL	$1.56	$9.09	83718
Cholesterol: LDL	$2.50	$9.85	83721
Cholesterol: Total	$1.54	$8.19	82465
Comprehensive Metabolic Panel (CMP)	$7.25	$8.65	80053
Creatinine Assay	$1.48	$4.03	82565
Creatine Kinase (CK) Assay	$3.16	$9.76	82550
Differential, Manual	$11.23	$16.88	85007
Electrolyte Panel	$3.21	$8.79	80051
Gamma-Glutamyl Transferase (GGT)	$4.43	$8.53	82977
Glucose	$1.52	$5.18	82947
Glucose Postprandial, 0 and 2 Hour	$1.52	$8.01	82950
Hepatic Function Panel	$2.80	$10.07	80076
Iron, Total	$8.04	$10.52	83540
Iron Binding Capacity, Total (TIBC)	$9.71	$10.07	83550
Lipid Profile Panel	$10.04	$31.89	80061
Magnesium	$8.88	$9.74	83735
Peripheral Smear Review	$8.62	$9.05	85008
Potassium	$1.53	$8.63	84132
Protein, Total	$1.60	$8.01	84155
Sodium	$1.53	$8.63	84295
Triglycerides	$1.54	$8.40	84478
Uric Acid	$4.62	$8.04	84550

According to it, the price for the lipid panel has increased three times from $10.04 to $31.89. The hepatic function panel rate has also risen from $2.80 to $10.07. If your lab processes high volumes through the South Texas lab, you must plan your budget before uploading them to your LIS.

How to Prepare for the September 1 Deadline?

The following steps help you prepare before the September 1 deadline arrives:

Download the official notice and file it. Keep the file as it’s solid evidence that helps you win legal cases.
Map every change into your LIS and billing software. Inactivate the four deleted codes: AFB probe (87149), Rubella IgG (86762), T3 uptake (84479), and urine microalbumin (82044).
Adjust allowed amounts for every fee change listed above. If your LIS holds separate fee schedules for performing lab, make sure both the Austin and South Texas profiles are updated independently.
Multiply your monthly test volumes for South Texas by the difference between the old and new fees. If the net result is a cost increase, adjust your lab’s financial forecasts. If you’re a reference lab passing through DSHS fees, update your client pricing accordingly.
Alert your ordering providers. Any clinic that routinely orders lipid profiles, hepatic function panels, or comprehensive metabolic panels through the South Texas lab needs a heads-up on the price changes. A short bulletin explaining the DSHS adjustment preserves trust and cuts down on confused billing inquiries.
Test on September 1. Submit a small batch of claims. Verify if payments match the new fee schedule. If there is a mismatch in your LIS, fix the root causes on time, so your billing is free of errors.

How Does Outsourcing Lab RCM Help You Stay Updated with the Fee Schedule?

It’s important to follow the fee schedule to submit claims for tests performed and receive reimbursements. But it isn’t an easy task for a busy lab handling thousands of tests a month to allocate time to search for a fee schedule and upload it to the LIS.

Professional lab billing partners help with that. If you outsource the process to dedicated providers for Texas laboratory billing services, such as TransLabs, it reduces your efforts, and the results are amazing. These billing companies are well-versed in changing state and payer policies. They can easily navigate the fee schedule changes and even help upload them into LIS. You don’t have to worry about that, while these billing partners handle everything.

Frequently Asked Questions

When will the 2026 Texas DSHS fee schedule be published?

DSHS typically posts the upcoming year’s fee schedule in the October to December window. Check the official DSHS laboratory page regularly starting in late fall. The effective date for any new fees is almost always January 1.

What if my lab bills a deleted code from the Texas DSHS fee schedule?

The claim will be denied. Your billing system should inactivate the old code and map any equivalent test to the active replacement code. If no direct replacement exists, contact DSHS for guidance before submission.

Will Medicaid managed care plans automatically use the new DSHS rates?

Some MCOs follow DSHS rates by reference, but others maintain their own schedules. Review each plan’s provider manual. A quick call to provider relations can confirm their timeline for adopting the new rates.

How can I estimate the financial impact before the official release?

You can’t pin down exact dollars, but you can model scenarios. Take last year’s test volumes and apply a reasonable range of change (+/- 2%) to high-volume codes. This gives you a ballpark number for budgeting. Once the real rates are out, replace estimates with actuals.

Does DSHS provide notice of specific deletions?

The updated spreadsheet of DSHS serves as notice, as any code not listed is effectively removed. DSHS sometimes includes a summary of changes tab, but don’t rely on it. Always do your own line-by-line comparison.

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