Texas Compassionate Use Program (TCUP) explained: who qualifies, how to get a prescription, and what the 2026 THC ban changed

Short answer: The Texas Compassionate Use Program (TCUP) is Texas’s medical cannabis program. A registered physician prescribes low-THC cannabis (up to 10 mg of THC per dose) for one of 13 named conditions, enters the prescription in the CURT registry, and you fill it at a licensed dispensary by showing your ID. There is no card and no state fee. The 2026 Texas hemp bans did not change TCUP.

Texas does medical cannabis differently from almost every other state: no card, no state fee, no patient portal. What you get is a prescription, entered by your doctor into a state registry, that a licensed dispensary looks up when you walk in.

This guide covers who qualifies as of October 2026, how to get a prescription, what you can buy, where to buy it, and what the 2026 THC bans did and did not change. If you already know you qualify, Leafwell’s Texas medical card page is where the evaluation starts.

What is the Texas Compassionate Use Program?

TCUP was created by the Texas Compassionate-Use Act (SB 339) in 2015 and is run by the Texas Department of Public Safety (DPS) under Health and Safety Code chapter 487. The rules for physicians sit in Occupations Code chapter 169.

Three pieces make it work:

• Qualified physicians. Only a Texas-licensed physician who is board-certified in a specialty relevant to your condition, and who dedicates a significant part of their practice to it, can prescribe (Occ. Code §169.002).
• The Compassionate Use Registry of Texas (CURT). A secure DPS database. Your “prescription” is literally an entry in CURT (Occ. Code §169.0011). It records your prescription details and every amount dispensed, and patient information in it is confidential by statute.
• Licensed dispensing organizations. Companies licensed by DPS to grow, process and dispense low-THC cannabis. They are the only legal source.

“Low-THC cannabis” now means any cannabis product containing no more than 10 milligrams of tetrahydrocannabinols per dosage unit. Until September 1, 2025, the cap was 1% THC by weight; HB 46 (89th Legislature) replaced the percentage with a per-dose milligram limit, added four condition categories, allowed inhalation devices and ordered DPS to license 12 more dispensing organizations.

DPS’s September 2026 report counts 174,777 patients listed in CURT by their physicians since the program began in 2017, and 979 approved physicians (DPS patient count report).

Who qualifies for TCUP? (2026 conditions list)

You need two things, both set in Occ. Code §169.003: you must be a permanent resident of Texas, and you must be diagnosed with one of the conditions below. The physician must also decide that the risk of medical use is reasonable in light of the potential benefit for you. There is no catch-all and no age limit in the statute; DPS says patients under 18 may need a legal guardian to pick up for them.

Source: Occ. Code §169.003 and the DPS patient FAQ, checked October 2026.

Can you get a medical card for anxiety in Texas?

No. Anxiety is not a named TCUP condition, and neither are depression, insomnia or ADHD. Texas has no physician-discretion route, so a doctor cannot prescribe for a diagnosis that is not on the list. PTSD is listed; generalized anxiety is not. If you have a listed diagnosis as well, that is what the physician evaluates. Our guide to why medical card applications get turned down covers the other common reasons.

How to get a TCUP prescription (step by step)

1. Check the two fixed requirements. Permanent Texas residency and a diagnosis on the list above. Leafwell’s Texas medical card page walks through what to have ready, and the evaluation starts there.
2. Book an evaluation with a TCUP-registered physician. You can search DPS’s CURT physician list (only doctors who opted in to publication appear) or use a telehealth service like Leafwell, which connects you to a Texas-licensed physician online. Bring records that document your diagnosis. Physicians charge for the visit; the state does not. What that typically costs is covered in our medical card cost guide.
3. The physician evaluates you. They must certify the diagnosis and judge that medical use is reasonable for you. A visit is an evaluation, not a guarantee.
4. Your physician enters the prescription in CURT. You do nothing. There is no state application, no fee and no card. DPS: “Statute does not require patients to register or pay a fee.”
5. Fill it at a licensed dispensing organization. Bring photo ID and give your last name, date of birth and the last five digits of your Social Security number; the dispensary looks you up in CURT. A legal guardian listed in CURT can pick up for a minor.
6. Refills and renewal. A prescription covers a 90-day supply and may include up to four refills (Occ. Code §169.003(b)). When those run out you need a new evaluation. See renewing your Texas prescription and the general renewal guide.

What can you buy and how much?

The limits are written into the statute, not set by the dispensary:

• 10 mg of THC per dosage unit, maximum (Occ. Code §169.001(3)).
• 1 gram of total THC per package, or per inhalation device (H&SC §487.107(c)). Your physician can prescribe more than one package per 90-day period.
• Forms: anything taken by ingestion, absorption or insertion (tinctures, gummies, lozenges, patches, lotions, suppositories) plus, since HB 46, pulmonary inhalation of an aerosol or vapor where the physician documents a medical necessity. Inhalation devices must meet HHSC rules.
• Smoking is excluded from the legal definition of medical use. Smokable flower is not sold under TCUP.
• Plant-derived only. Dispensaries may not sell products containing cannabinoids that are not naturally produced by the plant (H&SC §487.1071). That rules out synthetic or chemically converted cannabinoids.
• No home growing. Only licensees may cultivate.

Possession of prescribed low-THC cannabis bought from a licensed dispensing organization is exempt from the state marijuana possession offense (H&SC §481.111(e), per DPS). Cities and counties cannot ban TCUP cultivation, dispensing or possession (H&SC §487.201).

Where to buy: licensed dispensing organizations

As of October 28, 2026, DPS lists three active licensees: Fluent (formerly Cansortium Texas, license #0004), Texas Original (#0005) and goodblend (Surterra Texas, #0006). HB 46 lets licensees store product at approved satellite locations (H&SC §487.1035), so pickup sites are spreading beyond the three primary facilities. Check each licensee’s site for current pickup locations, or see our local guides for Houston, Austin and San Antonio.

Twelve more licenses are coming. HB 46 raised the cap to 15, and in a May 8, 2026 announcement DPS conditionally awarded licenses to Verano Texas, GTI Texas (RISE Dispensaries), Trulieve TX, Lone Star Bioscience, Lonestar Compassionate Care Group, Texas Patient Access, Bluebonnet Technologies, Sawtooth Texas, Bayou City Medical Dispensary, Dilatso, Texa OP (TexaRx) and PC TX OPCO (PharmaCann), spread across the state’s public health regions. A conditional license does not allow sales; each company must pass DPS due diligence and open within 24 months of final licensure. None of the twelve appears on the DPS active list yet.

Does the Texas THC ban affect TCUP patients?

No. Every 2026 action targeted consumable hemp products regulated under Health and Safety Code chapter 443 and the state controlled-substance schedules. TCUP products are prescribed, plant-derived and sold under chapter 487. Nothing in the hemp rules touches a CURT prescription or a licensed dispensing organization.

What did change, as of October 2026 (Texas State Law Library, DSHS):

• Vapes (2025). Selling e-cigarette products containing any cannabinoid is a Class A misdemeanor (H&SC §161.0876).
• Smokable hemp (March 31, 2026). DSHS rules now count THCA toward the 0.3% THC limit, which took nearly all hemp flower and pre-rolls off shelves. Buyers of any hemp product must be 21 or older and show ID.
• Delta-8 and other converted THCs (July 31, 2026). After the Texas Supreme Court sided with DSHS in DSHS v. Sky Marketing (May 1, 2026), manufactured delta-8, delta-10 and similar isomers became Schedule I under the state schedules. Roughly 14,000 registered hemp retailers had to pull them.
• Still legal: hemp-derived delta-9 edibles, drinks and tinctures at or below 0.3% delta-9 THC by dry weight, for adults 21 and over.

Lawsuits against both the March and July rules are pending in state and federal court. As of October 2026 no court order blocks either rule: the Fifteenth Court of Appeals has left the smokable-hemp rules in force while the appeal runs, and a federal judge in Galveston denied an emergency request to pause the delta-8 rule in August 2026.

The bigger change is federal. Under H.R. 5371 §781, as delayed by H.R. 6500 (signed September 2, 2026), cannabinoids the hemp plant cannot produce on its own lose federal “hemp” status on November 12, 2026, and on December 11, 2026 hemp is redefined by total THC (including THCA) with a cap of 0.4 mg of total THC per container for finished products (Foley Hoag). That ends most hemp-THC gummies and drinks nationwide unless Congress acts. TCUP products are not hemp, so it does not reach them. Our explainer on the federal hemp THC ban has the detail, and Is weed legal in Texas? covers possession penalties for everyone else.

Will the ban affect dispensaries? Hemp shops, yes. TCUP dispensing organizations, no; they are expanding, not closing.

TCUP vs a medical card in other states

If you have held a card elsewhere, expect these differences:

• No card. Your proof is the CURT entry; you show government ID at the dispensary.
• No state fee and no patient application. The physician does the registering. The only cost is the physician visit.
• Prescription, not recommendation. It specifies dose, form and total amount, and runs as a 90-day supply with up to four refills rather than a one-year card.
• No reciprocity. DPS confirms an out-of-state prescription cannot be filled in Texas, and other states’ reciprocity rules are built around a state-issued card, which Texas does not give you. Check the destination state before travelling.
• Tighter products. 10 mg per dose, 1 g THC per package, no smoking, no flower, no home grow.
• Gun licensing. DPS says CUP participation does not in itself disqualify you from a Texas License to Carry. Federal law (18 U.S.C. §922(g)(3)) is unresolved and unchanged, so nothing about TCUP makes firearm ownership federally safe.
• Federal status. State-licensed medical cannabis has been Schedule III federally since April 28, 2026; recreational cannabis remains Schedule I. A CURT prescription changes nothing about employment drug testing, federal property or travel.

This article is general information, not legal advice. Check the DPS Compassionate Use Program pages for the current rules, and if you think you qualify, start with a Texas evaluation.