Effective October 1, 2009, pharmacies and pharmacists can begin enrolling in the Children with Special Health Care Needs (CSHCN) Services Program to administer immunizations to CSHCN Services Program clients.

To enroll in the CSHCN Services Program, a pharmacist must obtain and provide proof of Texas Board of Pharmacy certification to administer vaccinations. A criminal background check will be performed on all pharmacists who enroll as performing providers under a group. All providers who enroll in the CSHCN Services Program must first be enrolled in Texas Medicaid.

A pharmacy with at least one performing provider (pharmacist) who is certified to administer immunizations can enroll in the CSHCN Services Program as a group provider. Pharmacies that are currently enrolled as durable medical equipment (DME) providers with either Texas Medicaid or the CSHCN Services Program can use a shortened enrollment application called the Texas State Health-Care Deeming Form to enroll as a pharmacy that administers vaccines.

Any pharmacy that is eligible for the shortened enrollment process will also receive a CSHCN Services Program Texas Provider Identifier (TPI) and a benefit code to be used in submitting claims. To retain an active CSHCN Services Program account, the pharmacy will be required to complete a CSHCN Services Program enrollment application within 6 months of the initial enrollment date.

Pharmacists that are directly employed by a pharmacy currently enrolled as a  DME provider with Texas Medicaid or the CSHCN Services Program can also enroll as performing providers using the Texas State Health-Care Deeming Form.

The CSHCN Services Program enrollment application  and Texas State Health-Care Pharmacy Deeming Form  are available on this website. Providers may also enroll using the online provider enrollment process . Providers enrolling with CSHCN are not required to provide a copy of their license unless it is expiring within the next 30 days.

Enrolled pharmacies and pharmacists can submit claims with dates of service on or after October 1, 2009. These claims may initially be processed as “Informational Only” or be denied as “procedure not covered for this provider type.” They will be reprocessed at a later date. Providers must still submit claims within the 95-day filing deadline.

General information about provider enrollment is available on this website. Providers can also refer to the 2009 CSHCN Services Program Provider Manual, section 29.2.23, “Immunizations (Vaccines and Toxoids),” on page 29-72 for additional information.