Texas Medical Marijuana in 2026: What HB 46 Changed and How to Get Certified

Texas's Compassionate Use Program underwent its most significant expansion ever on September 1, 2025, when House Bill 46 took effect — adding chronic pain and several other conditions, replacing the restrictive 1% THC cap with a 10mg-per-dose system, and authorizing 12 new dispensary licenses. The Marijuana Policy Project now recognizes Texas as the 40th state with a comprehensive medical cannabis program, a milestone a decade in the making. By the end of 2025, 135,470 patients were registered in the Compassionate Use Registry of Texas (CURT), a 32% jump over the prior year. For Texans exploring medical cannabis for the first time, the path to legal access is more straightforward than ever — no state fee, telemedicine-eligible evaluations, and same-day prescriptions through CURT-registered physicians.

HB 46 Transformed the Program on September 1, 2025

House Bill 46, authored by Rep. Ken King (R) and carried in the Senate by Sen. Charles Perry (R), was signed into law by Governor Greg Abbott on June 21, 2025. It passed the House 122–21 and the Senate unanimously, though its path included a contentious conference committee after the Senate initially stripped most qualifying conditions. The final version represents a hard-fought compromise that fundamentally restructured the Texas Compassionate Use Program.

The law's most impactful change is the addition of chronic pain — defined as continuous or intermittent severe pain lasting more than 90 days — as a qualifying condition. Critically, the final bill does not require patients to have first tried opioids, removing a barrier that was in earlier Senate drafts. The law also added traumatic brain injury (TBI), Crohn's disease, inflammatory bowel disease, terminal illnesses, and patients receiving hospice or palliative care. It is worth noting that glaucoma, degenerative disc disease, and spinal neuropathy were in the original House version but were removed during conference committee negotiations — a distinction several commercial certification platforms have incorrectly reported.

Beyond conditions, HB 46 replaced the previous 1% THC by weight cap with a milligram-based dosing system: 10 milligrams of THC per dose and a maximum of 1 gram (1,000 mg) of THC per package. This shift aligns Texas more closely with clinical dosing standards used in other states, though the caps remain more restrictive than most comprehensive medical programs, which impose no potency limits. New delivery methods were also authorized: lotions, patches, suppositories, and non-smoked pulmonary inhalation via vaporizers, inhalers, and nebulizers (devices must be approved by DSHS and directed by the patient's physician). Smokable flower remains prohibited.

Prescriptions are now valid for one year with four 90-day supply refills — a major improvement from the previous system. The Texas Medical Board oversees physician prescribing practices to prevent overprescription, and DPS and DSHS were required to finalize implementing rules by October 1, 2025.

Complete List of Qualifying Conditions as of 2026

Texas's qualifying conditions have expanded through four legislative actions since 2015. The current complete list, effective September 1, 2025, includes conditions from the original Compassionate Use Act (SB 339, 2015), HB 3703 (2019), HB 1535 (2021), and HB 46 (2025):

• Epilepsy and seizure disorders (2015)
• Multiple sclerosis (2019)
• Spasticity (2019)
• Amyotrophic lateral sclerosis (ALS) (2019)
• Autism spectrum disorder (2019)
• Incurable neurodegenerative diseases — an umbrella category covering Alzheimer's, Parkinson's, Huntington's, and dozens more (2019)
• Cancer — all forms, expanded from terminal-only (2021)
• Post-traumatic stress disorder (PTSD) (2021)
• Chronic pain — continuous or intermittent severe pain lasting 90+ days; no prior opioid use required (2025)
• Crohn's disease (2025)
• Inflammatory bowel disease (2025)
• Traumatic brain injury (TBI) (2025)
• Terminal illnesses (2025)
• Hospice or palliative care patients (2025)

Conditions not currently covered include standalone anxiety, depression, and migraines (though chronic migraine pain lasting 90+ days may qualify under the chronic pain provision). HB 46 also includes a provision allowing physicians to petition DSHS to add new qualifying conditions without new legislation — a mechanism that could expand the list further through administrative rulemaking.

From 3 Dispensaries to 15: The Dispensary Landscape Is Expanding

For most of its existence, Texas's program operated with just three licensed dispensing organizations: Texas Original (formerly Compassionate Cultivation, headquartered in Bastrop), Goodblend Texas (formerly Parallel/Surterra, based in Austin with locations in San Antonio and Plano), and Fluent (Cansortium Texas, primarily delivery-based). These three remain the only fully operational dispensaries as of early 2026.

HB 46 directed the Texas Department of Public Safety to issue 12 new dispensing organization licenses across two phases, bringing the total to 15. On December 1, 2025, DPS announced nine conditional Phase I selections from a pool of 132 applicants who originally applied during a 2023 application window. These conditional licensees include multi-state operators Verano (assigned to West Texas), PharmaCann (Southeast Texas/Houston area), and Trulieve (Texas Panhandle), alongside Texas-based companies including Texas Patient Access, Lonestar Compassionate Care Group, Lone Star Bioscience, Story of Texas, and TexaRx. State law gives licensing preference to Texas-based companies whose owners are state residents.

These conditional awards do not yet permit cultivation, manufacturing, or sales — each company must pass additional due diligence reviews including financial suitability and litigation history checks. Once finally approved, new licensees have 24 months to become operational. Industry estimates suggest 9 to 12 months for companies with existing out-of-state infrastructure. Phase II — three additional licenses open to first-time applicants — will be announced by April 1, 2026, targeting regions without Phase I coverage, including East Texas and parts of Central Texas.

The existing three dispensaries are simultaneously expanding through satellite locations, a new mechanism authorized by HB 46 that allows overnight product storage at secondary sites. Texas Original opened a new 75,000-square-foot facility in Bastrop in December 2025 and has announced plans for satellite locations in all 11 Texas public health regions within six months. Goodblend authorized its first satellite in San Antonio in December 2025, enabling same-day pickup and delivery to 18 South Texas counties. Before HB 46, products had to be returned to the main facility daily — a logistical burden that raised costs and slowed delivery times.

Product pricing at Texas dispensaries typically ranges from $40 to $70 per item. Available products include edibles, tinctures, topicals, THC-infused beverages, capsules, and lozenges. Vaporization products are pending DSHS device approval.

How to Get a Medical Marijuana Prescription in Texas

Texas does not issue physical medical marijuana "cards." Instead, the state uses an electronic prescription system through the Compassionate Use Registry of Texas (CURT), managed by DPS. Here is the current step-by-step process:

Step 1: Confirm eligibility. The patient must be a permanent Texas resident with a qualifying condition. There is no age minimum — minors require parental consent and a second concurring CURT-registered physician. Out-of-state patients are not eligible, and Texas has no reciprocity agreements with other states.

Step 2: Consult a CURT-registered physician. Only physicians who are licensed in Texas, board-certified by the American Board of Medical Specialties or Bureau of Osteopathic Specialists in a specialty relevant to the patient's condition, and registered in CURT can prescribe low-THC cannabis. Approximately 800 physicians are currently registered, out of roughly 80,000 board-certified physicians in the state — about 1%. Patients can search the DPS physician directory or book through telehealth platforms such as MMJ.com.

Step 3: Complete a medical evaluation. Evaluations can be conducted via telemedicine (video or phone) or in-person, typically lasting 10–30 minutes. Patients should have medical records documenting their qualifying condition. The physician must determine that the benefit of low-THC cannabis outweighs the risk for the individual patient.

Step 4: Receive your CURT prescription. If approved, the physician enters the prescription directly into CURT — often the same day. This electronic registration functions as the patient's legal authorization. There is no state fee for registration, making Texas one of the most affordable programs to enter. The only cost is the physician consultation, which ranges from $100 to $250 depending on the provider.

Step 5: Purchase from a licensed dispensary. Patients verify their identity at the dispensary using their name, date of birth, and last five digits of their Social Security number. Products can be ordered online for delivery or pickup at dispensary locations and satellite sites. Prescriptions are valid for one year with four 90-day supply refills.

Renewal requires a new evaluation with a CURT-registered physician. There is no separate state renewal process or fee. Insurance does not cover medical cannabis consultations or products. Texas also provides no workplace protections — employers may still enforce zero-tolerance drug-testing policies regardless of a valid TCUP prescription.

Ready to Get Your Texas Medical Marijuana Prescription?

If you have a qualifying condition and want to access Texas's Compassionate Use Program, MMJ.com can connect you with a CURT-registered physician for a fast, affordable telehealth evaluation. The process is simple:

1. Schedule your evaluation through MMJ.com — appointments are available via telemedicine
2. Get approved — most patients receive their CURT prescription the same day
3. Order from a licensed dispensary — products available for delivery statewide or pickup at dispensary and satellite locations

There is no state fee to register. Start your evaluation today and find out if you qualify under Texas's expanded program.

The 2025 Session Also Reshaped Hemp and THC Policy

HB 46 was only one piece of a volatile 2025 cannabis landscape in Texas. The legislature also passed SB 3, Lt. Gov. Dan Patrick's top legislative priority, which would have banned all consumable hemp-derived THC products statewide. Governor Abbott vetoed SB 3 on June 22, 2025 — one day after signing HB 46 — citing economic concerns and the lack of a sustainable regulatory framework. The veto set off a months-long political clash between Abbott and Patrick, with two special sessions failing to produce hemp regulation legislation. Abbott ultimately issued Executive Order GA-56 on September 10, 2025, directing DSHS and TABC to ban hemp THC sales to anyone under 21, require ID verification, and strengthen testing and labeling standards.

Separately, SB 2024 (signed June 20, 2025) banned the marketing and sale of vaporizers containing cannabinoids — including delta-8 THC — as a Class A misdemeanor. TCUP-prescribed vaporizers are explicitly exempted. Possession of cannabinoid vapes is not criminalized, only their sale.

The delta-8 THC market remains in legal limbo. Nearly 9,000 businesses were registered to sell hemp products in Texas, representing an estimated $8 billion industry. A Texas Supreme Court case on delta-8's classification remains pending. At the federal level, Congress enacted legislation in November 2025 redefining hemp based on total THC concentration rather than just delta-9 THC, effective November 2026, which will likely eliminate many current hemp-derived intoxicating products from the market.

Texas Still Trails Most States Despite Historic Progress

Even after HB 46, Texas's program remains more restrictive than the vast majority of medical cannabis states. The 10mg-per-dose THC cap contrasts sharply with states like Florida, Pennsylvania, Ohio, and Colorado, which impose no potency limits on medical products — patients in those states can access flower at 15–30% THC and concentrates exceeding 70% THC. Texas still prohibits smokable flower entirely.

The dispensary count underscores the gap. Florida operates 737 dispensary locations serving over 930,000 registered patients. Pennsylvania has 191 locations. California has roughly 3,659. Texas has 3 operational dispensaries (soon to be 15 licenses, though new ones won't be operational for months or years). Texas's delivery-based model and new satellite locations partially compensate but do not match the retail accessibility of most medical states.

On qualifying conditions, Texas's list of roughly 14 conditions (plus the neurodegenerative umbrella) is narrower than states like Oklahoma, which allows physician discretion for any condition, or New York, which lets doctors recommend cannabis for any condition they deem appropriate. However, the addition of chronic pain — the single most common reason patients seek medical cannabis nationally — was a transformative step that dramatically expanded the eligible patient population.

Public support for further reform is overwhelming. A February 2025 University of Houston poll found 79% of Texans support medical marijuana legalization (including 75% of Republicans), while 62% support full recreational legalization. The primary structural barrier remains the Texas Senate under Lt. Gov. Dan Patrick, who has blocked House-passed marijuana reform bills in multiple sessions. The Texas House has passed medical expansion and decriminalization bills with bipartisan supermajorities repeatedly — in 2019, 2021, 2023, and 2025 — only to see them die in the Senate. The 2025 session was the first time the Senate allowed a major expansion through, partly because Patrick used HB 46 as a vehicle to negotiate his hemp-THC ban priorities.

What to Watch in 2026 and Beyond

Several developments will shape the program's near-term trajectory. Phase II dispensary licenses will be announced by April 1, 2026, filling remaining geographic gaps. DSHS must still approve inhalation devices for vaporizer products — timing remains uncertain. New conditional licensees from Phase I will undergo due diligence and build out facilities over the next 12–24 months, meaning Texans won't see significantly more dispensary options until late 2026 or 2027.

At the federal level, President Trump signed an executive order on December 18, 2025, directing the Attorney General to expedite DEA rescheduling of marijuana from Schedule I to Schedule III. The DEA confirmed in January 2026 that the formal rulemaking process "remains pending." If finalized, rescheduling would eliminate IRC Section 280E tax burdens on cannabis businesses and formally recognize marijuana's medical value, though it would not legalize recreational use or authorize interstate commerce.

The Texas Legislature will not meet again in regular session until January 2027 (90th Legislature), meaning no further statutory expansion is possible before then. However, the new DSHS petition mechanism in HB 46 could allow administrative addition of new qualifying conditions before that time. With patient enrollment growing at 32% annually, new dispensaries coming online, and the broadest qualifying conditions in the program's history, Texas's medical cannabis landscape in 2026 represents a genuine inflection point — even as it remains, by national standards, a program still catching up.

Legislative Timeline of the Texas Compassionate Use Program

Year	Legislation	Key Changes
2015	SB 339	Created TCUP; intractable epilepsy only; 0.5% THC cap; 3 dispensary licenses
2019	HB 3703	Added MS, ALS, autism, spasticity, neurodegenerative diseases, terminal cancer; streamlined CURT
2021	HB 1535	Added PTSD and all cancer; raised THC to 1%; established research boards
2023	HB 1805 (died)	Passed House 127–19 with chronic pain and 10mg dosing; killed in Senate committee
2025	HB 46	Added chronic pain, TBI, Crohn's, IBD, terminal illness, hospice; 10mg/dose THC; 12 new licenses; satellite locations; new delivery methods
2025	SB 2024	Banned cannabinoid vape sales (TCUP exempted)
2025	SB 3 (vetoed)	Would have banned all consumable hemp THC products
2025	EO GA-56	Executive order: 21+ age gate on hemp THC, enhanced testing/labeling

Key Data Points at a Glance

Metric	Current Status (Early 2026)
Registered patients	135,470 (end of 2025; +32% YoY)
Registered physicians	~800 (~1% of TX physicians)
Operational dispensaries	3 (Texas Original, Goodblend, Fluent)
Total authorized licenses	15 (3 existing + 9 Phase I conditional + 3 Phase II pending)
THC limit	10 mg per dose; 1 g (1,000 mg) per package
State registration fee	$0
Physician consultation cost	$100–$250
Telemedicine eligible	Yes
Prescription validity	1 year (four 90-day refills)
Smokable flower	Prohibited
Workplace protections	None

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Frequently Asked Questions

What conditions qualify for medical marijuana in Texas?

As of 2026, Texas's Compassionate Use Program covers epilepsy, multiple sclerosis, spasticity, ALS, autism spectrum disorder, incurable neurodegenerative diseases (including Alzheimer's and Parkinson's), all forms of cancer, PTSD, chronic pain (lasting 90+ days), Crohn's disease, inflammatory bowel disease, traumatic brain injury, terminal illnesses, and patients receiving hospice or palliative care. Chronic pain is the broadest addition — no prior opioid use is required. See the full list of qualifying conditions.

How much does a Texas medical marijuana card cost?

Texas does not charge a state fee for CURT registration — it is $0. The only cost is the physician consultation, which typically ranges from $100 to $250 depending on the provider. There is no physical card; the prescription is entered electronically into the Compassionate Use Registry of Texas. Schedule an evaluation through MMJ.com.

Can I use telemedicine for a Texas medical marijuana evaluation?

Yes. Texas law allows CURT-registered physicians to conduct medical marijuana evaluations via telemedicine (video or phone call). Most evaluations take 10–30 minutes. If approved, the physician can enter your prescription into CURT the same day.

What is the THC limit in Texas?

HB 46 replaced the old 1% THC-by-weight cap with a milligram-based system: 10 milligrams of THC per dose and a maximum of 1 gram (1,000 mg) of THC per package. These limits are more restrictive than most medical marijuana states, which impose no potency caps. Smokable flower remains prohibited in Texas.

Does Texas have medical marijuana dispensaries near me?

As of early 2026, Texas has three operational dispensaries — Texas Original (Bastrop), Goodblend (Austin, San Antonio, Plano), and Fluent (delivery-based) — with satellite locations expanding statewide. All three offer delivery across Texas. Nine new Phase I licenses were conditionally awarded in December 2025, and three Phase II licenses will be announced by April 1, 2026, though new dispensaries won't be fully operational until late 2026 or 2027.

Does my employer have to accommodate my Texas medical marijuana prescription?

No. Texas provides no workplace protections for medical cannabis patients. Employers may enforce zero-tolerance drug-testing policies regardless of a valid TCUP prescription. A positive THC test can result in termination even if the patient is legally registered in the Compassionate Use Program. This is a significant difference from states like Arizona and Illinois, which offer cardholder employment protections.

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This article was last updated February 6, 2026. MMJ.com will continue to update this page as Phase II licenses are announced, new dispensaries become operational, and federal rescheduling developments unfold.

Texas Medical Marijuana Sources and References

1. Texas Legislature — HB 46 Bill Text — Full bill text, vote history, and conference committee report
2. Texas Department of Public Safety — Compassionate Use Program — CURT registry, physician directory, dispensary licensing
3. Texas Department of State Health Services — Product regulation, device approvals, implementing rules
4. Marijuana Policy Project — Texas — Program tracking, policy analysis, Texas as 40th medical cannabis state
5. University of Houston Hobby School of Public Affairs — February 2025 Poll — 79% Texan support for medical marijuana, partisan breakdown
6. Texas Legislature — SB 3 (Vetoed) — Hemp ban bill text and Governor Abbott's veto
7. Texas Legislature — SB 2024 — Cannabinoid vape sales ban
8. Texas Department of Public Safety — Phase I Conditional License Announcements (December 1, 2025)
9. Texas Original Compassionate Cultivation — Dispensary expansion, new Bastrop facility, satellite locations
10. Goodblend Texas — San Antonio satellite authorization, South Texas delivery
11. Compassionate Use Registry of Texas (CURT) — Patient enrollment data (135,470 registered patients, end of 2025)