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TPI Number Removed from CSHCN Services Program Forms and Instructions, Effective September 1, 2021

Last updated on 9/1/2021

Effective September 1, 2021, providers are no longer required to use their Texas Provider Identifiers (TPIs) for submitting paper claims, paper prior authorization requests, or for calling TMHP. The TPI fields have been removed from Children with Special Health Care Needs (CSHCN) Services Program authorization forms, prior authorization forms, miscellaneous forms, and form instructions.

Providers Must use Their NPIs Effective September 1, 2021

In place of TPIs, providers must submit their National Provider Identifiers (NPIs) and related data on forms. Providers or individuals who do not provide health-care services and who are not required to have NPIs may have been issued Atypical Provider Identifiers (APIs). These providers should use their APIs instead of the TPIs.

Using the NPI will save time and simplify administrative work for health-care providers:

  • The NPI is a single provider identification number that will be recognized and accepted by all health plans.
  • Providers will no longer need to report, maintain, or track multiple provider identification numbers; this will improve the efficiency and effectiveness of electronic health-care transactions.

Providers Should Stop Using TPIs by December 1, 2021

In place of TPIs, providers will need to submit their NPI/API, taxonomy code, benefit code (if applicable), and complete address with city, state, and ZIP+4 code.

The following forms and instructions have been revised and updated, and the forms will be available on September 1, 2021, as fillable PDFs on tmhp.com under “Forms,” and on TMHP’s Prior Authorization on the Portal:

Note: To promote a smooth transition as TPIs are phased out, TMHP will continue to accept older forms that include TPIs after September 1, 2021, until November 30, 2021. After this transition period ends, only the revised NPI/API-based forms will be accepted. Effective December 1, 2021, forms with TPIs will be returned, resulting in a delay in authorization approval or service reimbursement.

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