Texas Compassionate Use Program: How Medical Cannabis Works in Texas
Short answer: Texas doesn't issue a medical marijuana card. Instead, a physician registered with the Texas Compassionate Use Program (TCUP) prescribes low-THC cannabis to a qualifying patient through the Compassionate Use Registry of Texas, run by the Department of Public Safety (DPS). The patient fills the prescription at a state-licensed dispensing organization. House Bill 46, in effect since September 1, 2025, added chronic pain, traumatic brain injury, Crohn's disease and other inflammatory bowel diseases, and terminal illness or hospice and palliative care to the qualifying conditions. For hemp products sold at retail, see Is THC Legal in Texas?
Last checked: October 26, 2026. This page is general information, not legal or medical advice.
Who qualifies for the Texas Compassionate Use Program?
Under Texas Occupations Code §169.003, a registered physician may prescribe low-THC cannabis to a patient who is a permanent resident of Texas and is diagnosed with:
- Epilepsy
- A seizure disorder
- Multiple sclerosis
- Spasticity
- Amyotrophic lateral sclerosis (ALS)
- Autism
- Cancer
- An incurable neurodegenerative disease
- Post-traumatic stress disorder (PTSD)
- A condition that causes chronic pain, defined in the law as continuous or intermittent severe pain for more than 90 days (added in 2025)
- Traumatic brain injury (added in 2025)
- Crohn's disease or another inflammatory bowel disease (added in 2025)
- A terminal illness, or a condition for which the patient is receiving hospice or palliative care (added in 2025)
- A condition approved for a state-approved research program, for a patient receiving treatment under that program
The physician must also decide that the risk of low-THC cannabis is reasonable given the potential benefit for that patient. Only the Legislature can add qualifying conditions. A physician may submit evidence asking the Department of State Health Services to report to the Legislature that low-THC cannabis may help a specific condition. DPS rules for the program are in Title 37 of the Texas Administrative Code, Chapter 12, and DPS publishes program information on its Compassionate Use Program page.
How does the program work?
- Find a registered physician. Only physicians registered in the Compassionate Use Registry of Texas can prescribe low-THC cannabis. DPS offers a public physician search.
- Get evaluated. The physician confirms the diagnosis and decides whether low-THC cannabis is appropriate.
- Get the prescription entered. The physician enters the prescription in the registry. Each prescription covers up to a 90-day supply, with up to four refills.
- Fill the prescription. The patient, or a legal guardian, gets the product from a licensed dispensing organization and must show identification.
There's no card to carry, and patients don't register or pay a fee themselves; DPS says the statute does not require it. Prescriptions from other states can't be filled in Texas. Under state law, patient identification information in the registry is confidential: only DPS, registered physicians and dispensing organizations can access it, and it is exempt from public information requests.
How much THC can TCUP products contain?
Since September 1, 2025, low-THC cannabis can contain no more than 10 mg of THC in each dosage unit, replacing the old 1% by weight limit. Dispensing organizations can't dispense a package, container or inhalation device that contains more than 1 gram of THC in total.
Smoking isn't allowed under the program. A physician may prescribe inhalation of an aerosol or vapor when it's medically necessary for the patient's condition, using an approved device. The Health and Human Services Commission sets the device rules, and DSHS approved seven inhalation devices between January 9 and February 2, 2026.
How is TCUP different from hemp?
| Compassionate Use Program | Retail hemp products | |
|---|---|---|
| Who can buy | Registered patients with a prescription | Adults 21+ with ID |
| Where | State-licensed dispensing organizations | Licensed or registered retailers and online stores |
| THC limit | 10 mg per dosage unit, 1 g per package | 0.3% total delta-9 THC (delta-9 plus THCA) by dry weight |
| Inhaled products | Allowed by prescription when medically necessary (no smoking) | Vapes banned from sale |
| Federal December 11 change | Not hemp, so the federal hemp redefinition does not apply | 0.4 mg cap per container on total THC and similar cannabinoids combined |
Separately, a federal Drug Enforcement Administration rule effective April 28, 2026 moved marijuana subject to a state medical marijuana license to Schedule III. The rule does not mention low-THC programs, so whether it covers TCUP is unclear.
For how state law treats other cannabis products, see Is weed legal in Texas? and Is THCA legal in Texas?
How many dispensaries are there?
HB 46 directs DPS to issue 15 dispensing organization licenses, provided enough qualified applicants apply. Three were licensed before the law took effect, and as of October 26, 2026, the DPS licensed dispensaries page still lists those three as the active licensees.
DPS has conditionally selected 12 new licensees. Nine were announced December 1, 2025: Verano, Trulieve, Texas Patient Access, Lonestar Compassionate Care Group, Lone Star Bioscience, PharmaCann, TexaRx, Story of Texas and Dilatso. Three more were announced April 1, 2026: RISE (Green Thumb Industries), Texas Medica Collective and Cresco Labs. Conditionally selected applicants can't operate until DPS gives final approval, and licensees must be fully operational within 24 months.
Licensed organizations can also use approved satellite locations to securely store low-THC cannabis for distribution, with no more than one per public health region until each region has one.
Frequently asked questions
Can I get a medical marijuana card in Texas?
No. Texas doesn't issue cards. A registered physician prescribes low-THC cannabis through the Compassionate Use Registry, and patients don't pay a registration fee.
Does chronic pain qualify for medical cannabis in Texas?
Yes. A condition that causes chronic pain, defined as continuous or intermittent severe pain for more than 90 days, was added to the qualifying conditions effective September 1, 2025.
Do you have to live in Texas to use TCUP?
Yes. The law requires the patient to be a permanent resident of Texas, and prescriptions from other states can't be filled in Texas.
Is CBD part of the Compassionate Use Program?
Retail hemp CBD isn't part of TCUP; it's sold under separate hemp rules. TCUP's own low-THC cannabis products can contain CBD, because the program limits THC per dose. See Is CBD legal in Texas?
Sources
- Texas Occupations Code, Chapter 169
- Texas Health and Safety Code, Chapter 487
- House Bill 46 (89th Legislature), enrolled text
- Texas DPS: Compassionate Use Program
- Texas DPS: Summary of HB 46
- Texas DPS: Compassionate Use Program patient FAQ
- Texas DPS: Licensed dispensing organizations
- Texas DPS: Phase I expansion selection update (Dec. 1, 2025)
- Texas DPS: Phase II expansion selection update (Apr. 1, 2026)
- Texas DSHS: Approved pulmonary inhalation devices for low-THC cannabis
- Federal Register: DEA rescheduling rule (Apr. 28, 2026)
Not legal or medical advice. This page is general information about hemp and cannabis laws, not legal or medical advice. Laws change often, so this page may not reflect the latest developments. Reading it does not create an attorney-client relationship. For advice about your situation, talk to a licensed attorney in your state, and talk to a physician about medical questions.