The Texas Compassionate Use Program (TCUP) is the state’s medical cannabis program. Lawmakers created it in 2015 and expanded it in 2019 and 2021. House Bill 46, passed in 2025, was the largest expansion since the program began. This page tracks how the program has changed, starting with the most recent developments.
How the Compassionate Use Program works
The Department of Public Safety (DPS) administers and regulates the Compassionate Use Program. Through the program, DPS operates a secure online registry of qualified physicians who can prescribe low-THC cannabis to patients with specific medical conditions.
The registry, called the Compassionate Use Registry of Texas (CURT), is designed to prevent more than one qualified physician from registering as the prescriber for a single patient, is accessible to law enforcement agencies and dispensing organizations to verify patients of low-THC cannabis, and allows a physician to input safety and efficacy data derived from the treatment of patients for whom low-THC cannabis is prescribed.
DPS also manages the licensing of organizations that dispense low-THC cannabis to patients in the Compassionate Use Registry of Texas.
June 2026: Vaporization devices reach TCUP patients
In June 2026, Texas Original became the first licensed dispensing organization to launch a metered-dose vaporization device for TCUP patients, offering a faster-acting alternative to edibles and tinctures for conditions requiring rapid symptom relief. GoodBlend has also introduced inhalation products. These devices are available only through TCUP with a physician’s prescription.
May 8, 2026: DPS corrects the scoring of new license applications
All 12 new licenses authorized by HB 46 were issued as conditional licenses after a two-phase selection process in which the Department of Public Safety (DPS) scored 104 applications. After DPS posted the score sheets, Bayou City Medical Dispensary identified a tabulation error: the four statutory scoring exhibits had not been weighted equally at 25% each, as the published criteria required.
On May 8, 2026, DPS announced it would re-tabulate all scores using the correct method. The individual scores given by committee members did not change. Under the corrected rankings, three companies that were not among the original winners now qualify for conditional licenses, and three previously announced winners moved out of the top 12. Due diligence reviews continue for all conditional licensees.
At the same time, concentrate products became available through TCUP. The Department of State Health Services (DSHS) had approved a vape device for the program, but DPS had not yet authorized dispensaries to offer it.
March 2026: First satellite locations open
By March 2026, at least two existing license holders had opened satellite dispensing locations, which HB 46 allows so patients across the state’s public health regions have access. Three more licenses were expected by April 1, 2026.
December 2025: Nine new medical cannabis licenses issued
DPS issued conditional licenses to nine new businesses, expanding the number of TCUP operators from three to 12, with three more to follow:
- Verano Texas, LLC
- Lonestar Compassionate Care Group, LLC
- TexaRx
- Trulieve TX, Inc
- Lone Star Bioscience, Inc
- Story of Texas, LLC
- Texas Patient Access, LLC
- PharmaCann
- Dalitso, LLC
The new qualifying conditions added by HB 46 (chronic pain, traumatic brain injury, Crohn’s disease, and hospice or palliative care) were in effect, and DSHS had adopted rules for approving inhalation devices and for physicians to recommend additional conditions for lawmakers to consider.
Oct. 3, 2025: TCPC comments on the vape device rules
TCPC submitted public comments on the proposed rules implementing HB 46. We recommended that dispensing organizations, not physicians, be the ones to petition for approval of inhalation devices, and that petitions for new devices be resolved within six months.
Sept. 1, 2025: HB 46 takes effect
The new law went into effect, starting the clock on agency rules and the new licenses. See the official history of HB 46.
Aug. 21, 2025: HHSC Executive Council takes up TCUP rules
The Health and Human Services Commission Executive Council met to discuss and approve proposed TCUP rules for public comment. The proposed rules explained how physicians can request to add medical conditions to the program’s list and set standards and a review timeline for pulmonary inhalation devices.
Aug. 7, 2025: DPS outlines new rules and the licensing process
At the Aug. 7, 2025, Public Safety Commission meeting, DPS gave an update on licensing and previewed three proposed rules required by HB 46, covering future license applications, security standards for satellite locations and license revocation. DPS confirmed it would issue 12 new licenses, bringing the statewide total to 15, and opened a licensing window from Aug. 8 to Sept. 15, 2025.
June 20, 2025: Gov. Abbott signs HB 46 into law, expanding and improving the Compassionate Use Program
Gov. Greg Abbott signed House Bill 46 into law, ensuring a significant improvement and expansion of the Compassionate Use Program (TCUP). This big change makes Texas the 40th state to establish a comprehensive medical cannabis program!
The bill adds several qualifying conditions and allows the use of cannabis patches, lotions, and suppositories as well as approved inhalers, nebulizers, and vaping devices.
To ensure adequate patient access, HB 46 instructs the Department of Public Safety (DPS) to issue 15 dispensing licenses, which must be located strategically within Texas’ public health regions. The bill also allows dispensing organizations to open approved satellite locations. Find the full bill overview below.
While there are still shortcomings, including outrageous licensing fees and a real need for regulatory accountability, many more patients now have access to the program with more product choice.
Policy Overview: House Bill 46
Patient Access and Product Availability
- Prescriptions: Patients would be certified for 1 year, with (4) 90-day supply refills of medication. Prescriptions would be monitored by the Texas Medical Board.
- Product Availability: Allows the use of cannabis patches, lotions, and suppositories as well as approved inhalers, nebulizers, and vaping devices. Total THC is limited to 10mg/dose and 1 gram of THC per package. To be most effective, inhalable products (vape/inhalers) are not limited to 1% THC. Limits cannabinoids in products to natural phytocannabinoids.
- Qualifying Conditions: Grants access to program for patients with chronic pain, traumatic brain injury, Crohn’s disease, and any terminal illness or condition for which a patient is receiving hospice or palliative care.
Licensing and Regulation
- Limited Licenses: Department of Public Safety (DPS) would be required to issue 15 total licenses.
- Regional Access: New or renewed licenses would be issued strategically to ensure adequate patient access in each of Texas’ public health regions.
- Satellite Locations: With approval from DPS, licensed dispensing organizations could open one or more satellite locations in addition to their primary location. Requires DPS to establish rules about the design and security of satellite locations.
- Active Licenses: Dispensing organizations would be required to begin operations within 24 months of receiving their license and must maintain production in order to retain their license. All new dispensaries must be 1,000 ft. from any school.
- Licensing Process: DPS will issue nine additional licenses by Dec. 1, 2025 and three additional licenses must be issued by April 1, 2026.
- Pulmonary Inhalation: The Department of State Health Services (DSHS) commissioner will establish rules relating to products/devices for the purpose of pulmonary inhalation (inhaler, vape, nebulizer).
- Prescription Monitoring: The Texas Medical Board (TMB) will establish rules and procedures for oversight and monitoring of physicians to prevent over prescribing.
HB 46 goes into effect on September 1, 2025 and all necessary DPS and DSHS rules must be adopted by October 1, 2025. TMB must adopt rules for monitoring prescriptions as soon as reasonably possible.
June 1, 2025: Medical Cannabis Expansion Bill Heads to Gov. Abbott’s Desk
Last night (June 1, 2025) was a big deadline for the House and Senate to approved Rep. Ken King’s HB 46. With bipartisan support, the bill was approved in time and will significantly expand the Texas Compassionate Use Program. This is great news for the MANY Texas patients who will now qualify for legal access to medical cannabis!
House Bill 46 adds the following qualifying conditions: chronic pain, traumatic brain injury, Crohn’s disease, and any terminal illness or condition for which a patient is receiving hospice or palliative care. The new law allows the use of cannabis patches, lotions, and suppositories as well as approved inhalers, nebulizers, and vaping devices. Prescriptions will be valid for one year, with (4) 90-day supply refills. Products may contain up to 1% total THC and no more than 10mg/serving and 1gram/package.
To ensure adequate patient access, HB 46 instructs the Department of Public Safety (DPS) to issue 15 dispensing licenses, which must be located strategically within Texas’ public health regions. The bill also allows dispensing organizations to open approved satellite locations.
If approved by the governor, HB 46 would go into effect on September 1, 2025 and all necessary rules must be adopted by October 1, 2025. Nine new business must be licensed by Dec. 1, 2025 and an additional 3 new licenses must be issued by April 1, 2026.
May 30, 2025: Texas House Rejects Watered Down Senate Version of HB 46
Chairman King’s excellent medical cannabis bill - HB 46 - passed the House with overwhelming bipartisan support. Unfortunately, when the bill moved to the Senate, it was weakened by Sen. Perry, who stripped away key provisions — including many qualifying medical conditions and critical business licensing opportunities.
But Chairman King isn’t backing down! When HB 46 returned to the House yesterday (May 30, 2025), he rejected the watered-down version. Now, House and Senate leaders have formed a conference committee to reconcile the differences. (See a side-by-side comparison above.)
House Appointees: Rep. Ken King (Chair), Rep. Giovanni Capriglione, Rep. Katrina Pierson, Rep. Tony Tinderholt, and Rep. Chris Turner.
Senate Appointees: Sen. Charles Perry (Chair), Sen. Paul Bettencourt, Sen. Bryan Hughes, Sen. José Menéndez, and Sen. Tan Parker.
Chairman King is standing firm — fighting for a stronger, more inclusive Compassionate Use Program for Texas patients!
The Conference Committee report due by MIDNIGHT TONIGHT! (May 31, 2025)
May 27, 2025: Senate Amends and Passes HB 46, Expanding TCUP
House Bill 46 aims to improve the Texas Compassionate Use Program (TCUP) and has evolved at nearly every stage of the legislative process. After passing the House as a great bill to improve and expand TCUP, the bill was amended by the Senate State Affairs Committee to be far more restrictive.
Late on Tuesday, May 27, 2025, the Texas Senate amended and passed HB 46. Several amendments were offered by the bill sponsor, Sen. Charles Perry, to further expand the program and provide guidance for the licensure process. A full breakdown of the bill as amended in the Senate can be found here.
Status**:** 05/27/2025 Passed by the Senate Unanimously
Next Step**:** Final House Approval (or Conference Committee)
HB 46 passed unanimously and now heads to the House for final consideration. The House can concur with Senate amendments and send the bill to Governor Abbott or they can contest the amendments and send the bill to conference committee.
Here’s a look at the Senate amendments:
- Any TCUP business owners with more than 10% stake in the company are required to submit fingerprints for a background check and register with the Department of Public Safety (DPS). (This is controversial.)
- DPS will issue nine additional licenses. The first three licenses must be issued by Oct. 1, 2025 and they must be issued to companies from the pool of applicants from 2023. An additional six licenses must be issued by April 1, 2025. Preference will be given to Texas companies when possible.
- Satellite locations are no longer required in each public health region before a second location can be opened in any single region.
- Patients may purchase up to a 90-day supply with three refills.
- Additional Qualifying Conditions: Chronic pain or a terminal condition while in hospice care. Chronic (vs acute) pain defined by the Texas Medical Board and may require patients to use opioids for 90-days. Sen. Perry denied this during the debate, but his amendment includes this compulsory language.
- Rules must be proposed by Oct. 1, 2025.
May 23, 2025: Senate State Affairs Committee Amends and Advances HB 46
On Friday, May 23, 2025, the Senate State Affairs Committee adopted an amended version of HB 46 with significant changes. Listen to the meeting here.
Most concerning: the House-approved list of qualifying conditions was stripped down to only include terminal patients in hospice care. The bill also strips patient protections and privacy.
The committee substitute for HB 46 cuts access for patients with chronic pain, glaucoma, traumatic brain injury, spinal neuropathy, Crohn’s disease or other inflammatory bowel disease, and degenerative disc disease. The only additional patients who would qualify to participate in TCUP are those with a terminal illness or condition and who are actively receiving hospice care. The substitute also removes language that would have granted DSHS authority to add new qualifying conditions.
A full breakdown of the bill as amended in committee can be found here. Sen. Perry has indicated that he’ll be offering further amendments on the floor.
LATEST NEWS: Late on May 25, 2025, Rep. Oliverson announced that he and Lt. Gov Patrick have come to an agreement on the final bill.
May 19, 2025: Initial Senate State Affairs Committee Hearing on HB 46
Monday, May 19, 2025, the Senate State Affairs Committee hosted a very quick hearing for HB 46, Chairman King’s medical cannabis bill.
“There will be a committee substitute, but we haven’t gotten it back from legislative council yet.” - Sen. Perry
Sen. Perry did acknowledge that cannabis is medicine and patients should have access to it. He also implied that the viability of this bill is dependent upon the success of SB 3 banning “intoxicating” hemp. We knew that was the game they’re playing, but to hear it so clearly this morning really puts into perspective the fact that they are holding medicine hostage in order to fulfill their goals of hemp THC prohibition.
The committee will take up the bill again when their revised draft is ready. Since they took testimony at today’s hearing, they will not be required to hear from people again.
Senate State Affairs Committee Hearing
May 19, 2025 - Begins @54:05
May 12 and 13, 2025: Texas House Passes HB 46
With a bipartisan super-majority vote of 122-21, the Texas House of Representatives has passed Chairman King’s HB 46 to expand and improve patient access to medical cannabis.
Next Step: HB 46 was referred to the Senate State Affairs Committee on May 14, 2025, and the committee held a public hearing on May 19, 2025.
There were a few changes made through floor amendments, including Rep. Oliverson’s prescription monitoring and Chairman King’s own amendment improving patient access.
Chairman King’s amendment removed the 1 gram THC limit per package, changed the requirement from 11 to 15 business licenses total, removed the 1% cap on inhalation products, and removed the restriction on “naturally occurring chemical substance from the cannabis plant that is not a phytocannabinoid.”
How did your representative vote on HB 46?
NOTE: Rep. Ashby was absent, but made a note in the journal that he would have voted NO if he was present. Representatives Dorazio and Kerwin were shown as voting YES, but meant to vote NO. Representatives Pierson and Schoolcraft were shown as voting NO, but meant to vote YES.
The official journal for votes (May 12 and 13, 2025) on HB 46 can be found here.
April 14, 2025: House Committee Hearing on HB 46
On Monday, April 14, 2025, the House Public Health Committee hosted a hearing on Chairman Ken King’s HB 46. Witnesses waited more than 13 hours to testify in support of this bill, which would improve and expand the Texas Compassionate Use Program. Testifying witnesses included patients, caregivers, business operators, and medical professionals.
Chairman King’s committee substitute for HB 46 adds chronic pain as a qualifying condition. This is great news! This important change allows Texas patients to use cannabis as an alternative to opioids.
Chairman King closed out the hearing with the following:
“One thing that’s not talked about in here is hospice care. I’m gonna tell you right now, y’all have heard me a lot over the years talk about my mother. I watched her die over 10 1/2 weeks in hospice. And if I had it to do over again, instead of giving her the poison they were shoving down her, I would have gone to Colorado and bought a joint. That’s just me. I don’t use it myself, but I hope for your favorable consideration on this bill. And if you have suggestions, I’m open to them.” (Watch this moment.)
There may be further amendments to the bill before it’s passed out of committee. Stay tuned for updates!
HB 46 as introduced
House Bill 46 improves the Texas Compassionate Use Program (TCUP). The bill defines the allowable amount of THC in terms of milligrams (rather than % by weight), but legalizes the use of cannabis patches, lotions, and suppositories as well as approved inhalers, nebulizers, and vaping devices.
To ensure adequate patient access, HB 46 instructs the Department of Public Safety (DPS) to issue 11 dispensing licenses, which must be located strategically within Texas’ 11 public health regions. The bill also allows dispensing organizations to open approved satellite locations.
Learn more about HB 46 the committee hearing.
Spring 2025: Leading Medical Cannabis Legislation
SB 1505 - Medical Cannabis - Sen. Charles Perry (R)
Relating to the medical use of low-THC cannabis under and the administration of the Texas Compassionate-Use Program. Bill details.
Status: 03/13/2025 S Vote taken in committee (Passed Unanimously)
HB 46 - Medical Cannabis - Rep. Ken King (R)
Relating to the medical use of low-THC cannabis under and the administration of the Texas Compassionate-Use Program. Bill details.
Status: 04/14/2025 H Scheduled for public hearing.
Aug. 6, 2024: Texas Palliative Care Advisory Council Recommends Expanding TCUP
On August 6, 2024, the Palliative Care Interdisciplinary Advisory Council, met to discuss a variety of recommendations to the legislature, including one recommendation to expand the Texas Compassionate Use Program.
Palliative Care Interdisciplinary Advisory Council was established to assess the availability of patient-centered and family-focused palliative care in Texas. The council consults with and advises the Texas Health and Human Services Commission (HHSC).
During the council’s discussion, Dr. Larry Driver from Houston spoke in support of the recommendation, “We’re all in agreement that medical cannabis, especially in a palliative care setting, needs to at least be a part of the Compassionate Use Program. There needs to be more work done and I would hope that the state would endorse research into the potential benefits of THC and CBD.”
The council approved the recommendation to expand the Texas Compassionate Use Program and it was included in their report to lawmakers who convene in January for the 89th Texas Legislative Session.
Watch the meeting here.
Before 2025: TCPC’s recommendations for the program
Written before HB 46 became law in June 2025. Some of these changes were made by HB 46.
Top Recommendations to Make TCUP More Inclusive:
- Allow doctors decide if a patient could benefit from medical cannabis. At minimum, allow pain patients to use cannabis as an alternative to opioids.
- Allow doctors to decide what THC dosing is right for each patient; Remove THC limit and shift from %THC by dry weight to #mg per serving.
- License more businesses without required vertical integration. Allow multiple secure dispensing locations for each licensed business.
- Allow third party lab testing. Independent laboratories are already licensed and regulated. Allowing independent testing ensures consumer protection.
Qualifying Conditions
Current Law: PTSD, autism, cancer, epilepsy, seizure disorders, multiple sclerosis, spasticity, amyotrophic lateral sclerosis, incurable neurodegenerative disorders like Alzheimer’s and Parkinson’s, or medical conditions approved for research by the commissioner of the Department of State Health Services.
Recommendation: Allow doctors to decide if cannabis can help a particular patient. At minimum, add the following conditions:
- Chronic Pain (alternative to opioids)
- HIV/AIDS and Wasting or Cachexia
- Traumatic Brain Injury
- Crohn’s disease, Ulcerative Colitis
- Severe or persistent nausea
Types of Medicine
Current Law: Low-THC, limited to 1% by weight.
Recommendation:
- Allow doctors to decide what THC dosing is right for each patient.
- Remove THC limit and shift from %THC by dry weight to #mg per serving.
- Allow vaporization for rapid uptake and immediate relief for patients.
Additional Policy Recommendations:
- “Reciprocity”: Add protections for patients visiting from and registered in other states
- Patient Protections: Secure gun rights, protect child custody, eliminate state discrimination (benefits, drivers license, professional license, state employment), ensure organ transplant eligibility.
- Cannabis business licensing fees are extraordinarily high. Reasonable fees would protect small business access to the market and keep cannabis medicine from being cost prohibitive.
- Instruct DPS to issue additional licenses to qualifying applicants and allow vertical integration.
2015 to 2021: The Compassionate Use Program is created and expanded
The Texas Compassionate Use Program (TCUP) was established in 2015. The Legislature expanded the program in 2019 and again in 2021, providing access to low-THC (1%) cannabis for those with certain medical conditions.