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Increased Provider Enrollment Application Fee and Updated Enrollment Application Forms

Last updated on 12/16/2020

The enrollment application fee for institutional providers for the calendar year 2021 has increased to $599. This application fee for institutional providers will be required in the following instances:

  • Providers initially enrolling in Medicaid, Medicare, and the Children’s Health Insurance Program (CHIP)
  • Providers revalidating their Medicaid, Medicare, or CHIP enrollment
  • Providers adding a new Medicare practice location

This fee has increased from $595, and is required for any enrollment application submitted on or after January 1, 2021, through December 31, 2021.

Note: Providers that are required to pay the application fee, but have already paid the fee to Medicare, or another state’s CHIP or Medicaid program, have fulfilled the requirement and are not required to pay the fee to Texas Medicaid or the CSHCN Services Program. Proof of payment must be submitted with the application.

The following provider enrollment applications and FAQ document will be updated January 1, 2021:

Note: For paper applications submitted to TMHP, the TMHP Provider Enrollment Department will accept previous versions of the above referenced applications from January 1, 2021, through February 28, 2021. As of March 1, 2021, TMHP will only accept the revised versions of the applications posted on this website. Previous versions of the applications, submitted on or after March 1, 2021, will be marked as deficient and returned to the provider with a request that the correct version of the application be submitted with all required documentation.

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.