The primary care provider has a responsibility to provide continuous health care coverage 24 hours a day, 7 days a week for PCCM clients. The primary care provider is required to inform clients of how they can access after-hours care. If a PCCM client requests after-hours care, the FQHC or RHC must contact that client's primary care provider and refer the client to the PCCM Nurse Helpline at 1-800-304-5468. If the client is seen, the FQHC or RHC is responsible for contacting the primary care provider to obtain the Texas Provider Identifier (TPI) that is required in Block 17A of the CMS-1500 claim form for appropriate claims processing.

For more information, call the PCCM Provider Helpline at 1-888-834-7226 or the TMHP Contact Center at 1-800-925-9126.