Texas Medical Cannabis Sees Major Expansion Under HB 46 and Updated Agency Regulations

Published: 1 December 2025

Updated: 5 December 2025

The Texas Department of Public Safety has moved ahead with the first phase of new license selections under the Texas Compassionate Use Program (TCUP). Nine companies were chosen for conditional approval and will now face further review before any final licenses are issued. Regulators have since confirmed that the nine conditional approvals represent the first step in a larger expansion that will increase the number of dispensing organizations from three to fifteen, in line with new rules and legislative directives implemented throughout 2025.

The selections mark Phase I of a two-step process created under House Bill 46. The law directs state officials to issue a total of 12 new medical cannabis dispensing licenses, bringing the statewide total to fifteen once the expansion is complete.

House Bill 46 also broadens eligibility by adding:

• chronic pain,
• traumatic brain injury,
• Crohn’s disease,
• other inflammatory bowel diseases and qualifying circumstances for patients in palliative or hospice care.

For now, none of the selected companies can grow, make, or sell medical cannabis products. Each must first pass added checks tied to finances, past lawsuits, and any regulatory or criminal history. State officials indicated that fees will not be billed until those reviews are complete. DPS has reiterated that due diligence reviews will determine which applicants receive final approval, and that license invoicing will begin only after all compliance and financial verifications clear.

Conditionally Selected TCUP Applicants by Region

The nine companies moving forward, along with their public health regions, are listed below:

• Region 1: Trulieve TX, Inc.
• Region 2: Dilatso, LLC
• Region 3: Texas Patient Access, LLC
• Region 3: Lonestar Compassionate Care Group, LLC
• Region 6: PC TX OPCO LLC, operating as PharmaCann
• Region 6: Story of Texas, LLC
• Region 8: Lone Star Bioscience, Inc.
• Region 10: Verano Texas, LLC
• Region 11: Texa OP, operating as TexaRx

State officials said conditional status does not mean approval is guaranteed. If any applicant fails the next stage of review, the license may be denied.

What House Bill 46 Changes for Texas Medical Cannabis

House Bill 46 expanded the number of medical cannabis dispensing licenses allowed in Texas. The law calls for nine licenses in Phase I and three more by April 1, 2026. The legislation also addresses inhalation options by allowing pulmonary administration of low THC products under defined medical circumstances and requires that each inhalation device or product package be limited to one gram of total tetrahydrocannabinols. HB 46 further requires the registration of owners, managers and members of dispensing organizations and sets standards for satellite storage sites used to hold medical cannabis securely.

Texas has long operated one of the most limited medical cannabis programs in the country. Patient access is often shaped by travel distance, supply limits, and low competition. The new licenses may ease some of those pressures, though access is still likely to remain narrower than in many other states.

How the Texas Compassionate Use Program Works

The Texas Compassionate Use Program began in 2015 after Senate Bill 339 became law. The program is overseen by the Department of Public Safety rather than a health agency.

Under the program, approved doctors use the Compassionate Use Registry of Texas, known as CURT, to enter prescriptions for patients with qualifying medical conditions. Only low-THC cannabis products are allowed. All licensed dispensers are subject to site visits, product testing rules, and security standards.

In 2025, the Department of State Health Services finalized updated rules that let physicians formally request additions to the list of qualifying conditions. Such requests must be forwarded to DPS and then presented to state lawmakers during the next legislative session. Regulators also clarified that while physicians may approve low THC inhalation devices for patients, they are not obligated to do so. Dispensaries may request approval for new devices, but each submission must include a safety and efficacy attestation.

What This Could Mean for Texas Patients

If all nine firms clear the review process and the final three licenses are issued in Phase II, more Texans may gain closer access to medical cannabis over the next few years. The change may reduce travel times for some patients, though product options will still be limited by state law.

As of September 2025 more than 127,000 Texans were registered in the Compassionate Use Registry of Texas, and the increase from three to fifteen licensees is expected to reduce geographic bottlenecks. The expansion includes several large multistate operators, which some patients welcome, although others have expressed concerns about limited product diversity from the existing program.

At the same time, state officials continue to tighten rules surrounding intoxicating hemp products. DSHS recently issued emergency rules prohibiting the sale of intoxicating hemp items to customers under the age of 21. These rules follow unsuccessful legislative attempts to enact a broader statewide ban on hemp-derived THC products and align with an executive order from the governor.

At this stage, the timeline for full approval remains uncertain. State officials said the next phase of reviews will take place over the coming months.