TMPPM 2008 > Texas Medicaid Services > Physician Assistant (PA) > Enrollment

37.1 Enrollment

To enroll in the Texas Medicaid Program, a PA must be licensed and recognized as a PA by the Texas Medical Board. The Texas Medicaid Program accepts a signed letter of certification from the Texas Medical Board as acceptable documentation of appropriate licensure and certification for enrollment.

Providers cannot be enrolled if their license is due to expire within 30 days.

Enrollment as an individual provider is not mandatory. PAs currently treating clients and billing under the supervising physician's number can continue this billing arrangement.

All PA services must be delivered according to protocols developed jointly within the scope of practice and state law governing PAs.

All providers of laboratory services must comply with the rules and regulations of the Clinical Laboratory Improvement Amendments (CLIA). Providers not complying with CLIA are not reimbursed for laboratory services.

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 more information about enrollment procedures.

"CLIA Requirements" .

PAs may enroll as providers of Texas Health Steps (THSteps) medical check ups. Specific information may be found in the THSteps section of this manual. PAs should have expertise or additional education in the areas of comprehensive pediatric assessment.

Refer to: "Provider Enrollment" for more information about enrollment as a THSteps provider.