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Reminder: Provider Enrollment Revalidation Requirements

Last updated on 9/4/2020

Reminder: Providers must complete their revalidation enrollment before the end of their enrollment period. Providers can revalidate their enrollment up to 90 days before their deadlines through Provider Enrollment on the Portal (PEP), available on this website.

Providers can refer to the revalidation application type on the Provider Enrollment on the Portal, A Step-by-Step Guide for instructions on revalidation.

Providers who are unable to revalidate online must download and submit the appropriate paper enrollment application.

Providers who do not complete the revalidation process by their deadlines will be disenrolled from all Texas state health-care programs; claims and prior authorization requests will be denied.

Provider Requirements

Revalidating providers may need to provide fingerprints, submit additional documentation, or complete other screening requirements.

Providers may view and confirm their revalidation date and enrollment information through the Provider Information Management System (PIMS). To reduce application processing delays, providers are encouraged to update the following data elements prior to submitting a revalidation application:

  • First and last name
  • Organization name
  • Social Security number
  • Date of birth
  • Employer’s Tax Identification Number and legal name

Important: Providers who submit data element changes through the Provider Information Change (PIC) form must allow 30 business days from the time TMHP receives the form for the changes to take effect before they can complete the revalidation application.

Providers revalidating an existing enrollment should continue to submit claims to meet their timely filing requirements.

Certain revalidating providers must pay an application fee. Refer to the State of Texas Application Fee Requirement by Provider Service to determine which institutional providers must pay the provider enrollment application fee.

Providers can also refer to the current Texas Medicaid Provider Procedures Manual, General Information, Vol. 1, “Provider Enrollment and Responsibilities,” for more information.

For more information, call the TMHP Contact Center at 800-925-9126.