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.
This is an update to the article titled “Public Health Emergency Enrollment Application Now Available,” which was posted on this website on April 1, 2020.
Effective August 1, 2021, the Texas Medicaid Public Health Emergency Enrollment Application is discontinued and no longer available for download from tmhp.com.
The Public Health Emergency Application is a limited, temporary enrollment process. Providers who enroll with this application can be reimbursed for Medicaid and Children with Special Health Care Needs (CSHCN) Services Program services rendered from March 1, 2020 through the end of the federal public health emergency.
Providers who enrolled with the limited Public Health Emergency Enrollment Application during the COVID-19 public health emergency must complete all mandatory state and federal screening requirements by February 1, 2022 to remain enrolled with Texas Medicaid and the CSHCN Services Program.
Based on the submitted application, items that were waived as part of the limited Texas Medicaid Public Health Emergency Enrollment Application may be required for mandatory screening with TMHP:
- Application fee
- Site visits
- In-state licensure requirement, if they have equivalent licensing in another state
- Out of state/border state supporting documentation
- Medicare prerequisites
Providers can start the TMHP enrollment process found on the Provider Enrollment web page at tmhp.com.
Online enrollment has the following advantages for providers:
- Applications are validated immediately to ensure that all fields are completed.
- Most of the application can be completed online; only a few forms need to be printed, completed, and mailed to TMHP.
- Applicants can view both incomplete and completed applications submitted online.
- Providers can complete the Provider Information Change form online through the Provider Information Management System (PIMS).
For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.