TMPPM 2008 > Texas Medicaid Services > Texas Medicaid (Title XIX) Home Health Services > Enrollment

24.1 Enrollment

To enroll in the Home Health Services Program, home health services and Home and Community Support Services (HCSSA) providers must complete the Texas Medicaid Provider Enrollment Application. Medicare certification is required for providers that are licensed as a Licensed and Certified Home Health Agency. Providers that are licensed as a Licensed Home Health Agency are not required to enroll in Medicare as a prerequisite to enrollment with the Texas Medicaid Program.

Licensed and certified home health agencies that are enrolled as Medicaid providers can provide personal care services (PCS) using their existing provider identifier.

PCS for clients younger than 21 years of age will be provided by the Texas Health and Human Services Commission (HHSC) under the PCS benefit.

Refer to: "Personal Care Services (THSteps-CCP Only)" .

To provide Texas Health Steps (THSteps)-Comprehensive Care Program (CCP) services, HCSSA providers must follow the enrollment procedures in Section 43.4, "THSteps-Comprehensive Care Program (CCP)."

Enrolled providers of durable medical equipment (DME) and/or expendable medical supplies will be issued a DME-Home Health Services Provider Identifier that is specific to home health providers. All DME providers must be Medicare-certified before applying for enrollment in the Texas Medicaid Program.

Providers may obtain the application by writing to the following address:

Texas Medicaid & Healthcare Partnership
Provider Enrollment
PO Box 200795
Austin, TX 78720-0795
1-800-925-9126
Fax: 1-512-514-4214

For prior authorization requests on the Home Health Services contact:

Texas Medicaid & Healthcare Partnership
Home Health Services
PO Box 202977
Austin, TX 78720-2977
1-800-925-8957
Fax: 1-512-514-4209

For general questions, such as claims history information, prior authorization history, procedure codes, procedural matters, or to verify if prior authorization has already been issued, call the TMHP Comprehensive Care Program (CCP)-Home Health Provider Line at 1-800-846-7470.

Important: All providers are required to read and comply with Section 1, Provider Enrollment and Responsibilities. In addition to required compliance with all requirements specific to the Texas Medicaid Program, it is a violation of Texas Medicaid Program rules when a provider fails to provide health-care services or items to Medicaid clients in accordance with accepted medical community standards and standards that govern occupations, as explained in Title 1 Texas Administrative Code (TAC) §371.1617(a)(6)(A). Accordingly, in addition to being subject to sanctions for failure to comply with the requirements that are specific to the Texas Medicaid Program, providers can also be subject to Texas Medicaid Program sanctions for failure, at all times, to deliver health-care items and services to Medicaid clients in full accordance with all applicable licensure and certification requirements including, without limitation, those related to documentation and record maintenance.

Refer to: "Provider Enrollment" for information about enrollment procedures.