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2012 Texas Medicaid Provider Procedures Manual

Gynecological and Reproductive Health and Family Planning Services Handbook : 2. Medicaid Title XIX family planning services : 2.1 Title XIX Provider Enrollment

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:
Subsection 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 4.1, “Enrollment ” in the Clinics and Other Outpatient Facility Services Handbook (Vol. 2, Provider Handbooks) for information about FQHC provider enrollment.
Section 7.1, “Enrollment ” in the Clinics and Other Outpatient Facility 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:
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.
Note:
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.

Texas Medicaid & Healthcare Partnership
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