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Reporting Provider Information Changes

Last updated on 7/2/2021

Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details.

Providers must report address changes (physical location or accounting), telephone number, name, federal tax ID, and any other information that pertains to the structure of the provider’s organization within 90 days of occurrence.

Maintenance of Provider Information

If a provider moves or has an address change and the new address is within the same Medicare locality, the provider must update their address information within 90 days of the change.

Providers that are not enrolled with Medicare must submit a new enrollment application to enroll each additional physical address.

Providers that are enrolled with Medicare can add the new address as an Alternate Physical Address, if the new address is within the same Medicare locality; otherwise, a new enrollment application must be submitted to enroll each additional physical address.

Important: Providers can log into the Provider Information Management System (PIMS) to make changes to their information. Providers are encouraged to update their information using the PIMS for instant updates and can refer to the Provider Information Management System (PIMS) User Guide for details.

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