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Current Location:  File Library/Provider Forms/Provider Enrollment

Note: Should you have landed here as a result of a search engine(or other) link, be advised that these files contain material that is copyrighted by the American Medical Association. You are forbidden to download the materials unless you read, agree to and abide by the provisions of the end user agreement. Read the end user agreement now (you will be linked back to here).

                                                             END USER AGREEMENT

The Texas Medicaid & Healthcare Partnership (TMHP) website File Library is a repository for documents and software that can be viewed, printed or downloaded. The TMHP File Library replaces TexMedNet. It is divided into categories which are listed below, denoted by file folder icons. To locate specific documents and software in the File Library you can browse the files, use the Search feature located at the top of the screen and filter documents and software by file type, size, and modification date. Use the Filter icon located above the file folder icons. Note: Only documents (not folders) in the File Library can be filtered. To open PDF files in the File Library, you need Adobe Acrobat Reader  software on your machine. TMHP recommends using Adobe Reader version 7.0 or later to view PDF files on the TMHP website.

Scroll Down to see all TMHP File Library Folders.

Copyright Acknowledgements

The five character codes included in the File Library are obtained from Current Procedural Terminology (CPT®), copyright 2008 by the American Medical Association (AMA). CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and procedures performed by physicians.

 

The responsibility for content of the File Library is with THHS and/or their designees and no endorsement for the AMA is intended or should be implied. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in the File Library. Fee schedules, relative values units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liabilities for data contained or not contained herein. Any use of CPT outside of the File Library should refer to the most current Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. Applicable FARS/DFARS apply.

 

CPT is a registered trademark of the American Medical Association.

 

The American Dental Association requires the following copyright notice in all publications containing Current Dental Terminology (CDT) codes:

 

Current Dental Terminology (including procedure codes, nomenclature, descriptors, and other data contained therein) is copyright © 2008 American Dental Association. All Rights Reserved. Applicable FARS/DFARS apply.

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TypeNameDescriptionFilterModifiedFile Size
IconAdd a Program FormTexas Medicaid Application for enrollment of an additional program type3/8/2004 8:43 AM232 KB
IconDeeming Form11/13/2009 4:41 PM72 KB
IconEFT Authorization AgreementElectronic Funds Transfer Authorization Agreement11/21/2007 10:54 AM37 KB
IconPIF1 Provider Information FormTexas Medicaid Provider Information Form1/10/2008 3:30 PM67 KB
IconPIF2 Principal Information Change1/10/2008 3:31 PM80 KB
IconProvider Change of Ownership Form4/16/2008 4:00 PM32 KB
IconProvider Enrollment Application FormTexas Medicaid Provider Enrollment Application10/23/2009 11:23 AM2085 KB
IconProvider-Information-Change-FormProvider Information Change Form8/14/2009 2:07 PM34 KB
IconTexas_STD_Credentialing_Application[1]4/16/2008 2:40 PM4824 KB
IconTexas_Vaccines_for_Children_Provider_Enrollment_Application12/17/2003 2:07 PM1448 KB
IconTHSteps ApplicationTHSteps Provider Enrollment Application1/18/2008 1:20 PM271 KB
IconTMHP Consulting Agreement Pediatrics3/26/2009 3:52 PM84 KB
IconTMHP_Dental_Provider_Enrollment_Application6/6/2008 4:40 PM2056 KB
IconCSHCN6/18/2009 3:42 PM
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