Introduction: Social determinants of health (SDoH) are non-medical factors that impact individuals’ health. The importance of integrating SDoH data in healthcare is increasingly recognized by stakeholders. SDoH can be documented in healthcare claims data using International Classification of Disease (ICD) 10 th revision codes Z55 – Z65. The objective of this study was to describe the documentation of SDoH Z-codes amongst Medicaid beneficiaries in Texas. Methods: Texas Medicaid medical and enrollment data files were provided by the Texas Health and Human Services Commission. Texas Medicaid insures approximately 4 million people each year. Beneficiaries with at least one claim associated with an ICD-10 code of Z55-Z65 between January 2016 and December 2019 were identified. Those 65+ years of age and others dually eligible for Medicare and Medicaid were excluded. Descriptive analyses were performed. Results: SDoH Z-code documentation was associated with ~1.2 million claims for 181,136 unique Medicaid beneficiaries. SDoH Z-code utilization increased over the years: 40,879 individuals in 2016, 42,668 in 2017, 46,281 in 2018, and 51,308 in 2019. Females (54.3%) and Hispanics (48%) comprised a majority of the beneficiaries with these codes, with an average age of 14.2±13.4 years. Beneficiaries with the most frequent SDoH documentation resided in Harris (17.0%), Bexar (8.7%), and Dallas (8.1%) Counties. Attention-deficit hyperactive disorder (11.8%) and depressive disorders (5.2%) were the most frequent diagnoses associated with SDoH documentation. Nearly 40% of beneficiaries (N=68,478, 37.8%) had documentation of “problems related to upbringing” (Z62). This was followed by “problems related to primary support group including family circumstances” (Z63) (N=42,378, 23.4%) and “problems related to education and literacy” (Z55) (N=28,848, 15.9%). Conclusion: A steady increase in SDoH Z-code documentation was observed amongst Texas Medicaid beneficiaries from 2016 to 2019, but represented a relatively small proportion of beneficiaries. Given the significance of SDoH in health outcomes, these codes are likely underutilized.