TMPPM 2011 > Gynecological and Reproductive Health, Obstetrics, and Family Planning Services Handbook > Medicaid Title XIX family planning services > Title XIX Provider Enrollment

2. Medicaid Title XIX family planning services

2.1 Title XIX Provider Enrollment

Physician, FQHC, and RHC providers may provide Title XIX family planning services for Texas Medicaid clients under the provider's Texas Medicaid provider number. No additional enrollment is required to provide Title XIX family planning services.

Refer to: Section 6.1, "Provider Enrollment" in the Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook (Vol. 2, Provider Handbooks) for information about physician provider enrollment.

Section 5.1, "Enrollment " in the Outpatient Services Handbook (Vol. 2, Provider Handbooks) for information about FQHC provider enrollment.

Section 8.1, "Enrollment " in the Outpatient Services Handbook (Vol. 2, Provider Handbooks) for information about RHC provider enrollment.

Family planning agencies must apply for enrollment with TMHP to receive an agency provider identifier. To be enrolled in Texas Medicaid, family planning agencies must meet the following requirements:

•Complete an agency enrollment application.

•Ensure that all services are furnished by, prescribed by, or provided under the direction of a licensed physician in accordance with the Texas Medical Board or Texas BON.

•Have a medical director who is a physician currently licensed to practice medicine in Texas, and submit a current copy of the medical director's physician license.

•Have an established record of performance in the provision of both medical and educational counseling of family planning services as verified through client records, established clinic hours, and clinic site locations.

•Provide family planning services in accordance with DSHS standards of client care for family planning agencies.

•Be approved for family planning services by the DSHS Family Planning Program.

Note: A rural health clinic (RHC) can also apply for enrollment as a family planning agency.

The effective date for participation is the date an approved provider agreement with Medicaid is established and the provider is assigned a Medicaid provider identifier.

Providers cannot be enrolled if their license is due to expire within 30 days. A current license must be submitted.

Refer to: Section 1: Provider Enrollment and Responsibilities (Vol. 1, General Information) for more information about enrollment procedures.

Subsection 6.3.6, "Benefit Code" in Section 6, "Claims Filing" (Vol. 1, General Information) for more information about benefit codes.