To enroll in Texas Medicaid, 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 Texas Medicaid must first be enrolled in Medicare.

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

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

The Texas State Health-Care Pharmacy Deeming Form is available on this website.

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 the TMHP website at www.tmhp.com. Providers can also refer to the 2009 Texas Medicaid Provider Procedures Manual, Appendix H, “Immunizations,” on page H-1 for additional information.