Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details.
Beginning December 14, 2019, Substance Abuse and Mental Health Services Administration (SAMHSA)-certified Opioid Treatment Providers (OTPs) licensed as a Narcotic Treatment Program can submit provider enrollment applications for Texas Medicaid through TMHP. Provider Enrollment on the Portal (PEP) will be available for enrollment on December 14, 2019.
A checkbox for the OTP provider type and the requirements for OTP will be added to PEP.
Required Licenses and Certifications
OTPs must be licensed by the Health and Human Services Commission as a Narcotic Treatment Program. OTPs must be actively enrolled in Medicare. OTP enrollment requires a Principal Information Form (PIF-2) for a medical director who is actively licensed as a physician by the Texas Medical Board or the appropriate state board where services are rendered.
Enrollment in Texas Medicaid Using Provider Enrollment on the Portal
OTPs are encouraged to enroll on TMHP’s Provider Enrollment on the Portal.
Online enrollment includes the following advantages:
- Applications are validated immediately to ensure that all fields are completed.
- Most of the application can be completed online so that only a few forms need to be printed, completed, and mailed to TMHP.
- Applicants can view both incomplete and complete applications submitted online.
- Providers can complete the Provider Information Change form online.
Texas Medicaid Enrollment Application
The paper Texas Medicaid Provider Enrollment Application for Facilities will include OTP beginning January 1, 2020.
A checkbox for the OTP provider type and the requirements for OTP will be added to the updated version of the paper application.
For more information, call the TMHP Contact Center at 800-925-9126.