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.
Texas Medicaid & Healthcare Partnership’s (TMHP) Provider Enrollment and Management System (PEMS) is coming soon.
Provider enrollment functions will be available through PEMS, and providers must use this new system to enroll in Texas Medicaid.
PEMS will automate and streamline the provider enrollment process by removing the requirement to use paper forms, simplifying the process for providers to complete their National Provider Identifier (NPI)-based enrollment. 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.
Using PEMS will result in the following benefits:
- PEMS eliminates the need for multiple Texas Provider Identifiers (TPIs), allowing providers to interact with all Texas Medicaid records in a single, easy-to-use system.
- PEMS will allow for Texas Medicaid enrollment in multiple state health-care programs from a single application. Real-time data validation will reduce errors and expedite the enrollment process.
- The message dashboard will provide timely online email notifications and related correspondence.
- PEMS will offer real-time availability to changes made to provider information and offer instant access to the status of provider enrollment applications.
- PEMS will allow clients to locate providers faster with the expanded Online Provider Lookup search functionality.
PEMS Training and Resources
Users must have a username and password to access videos in the LMS. To obtain a username and password, click the “Don’t have an account? Sign up here” link on the LMS homepage and complete the new user registration.
A PEMS instructional video series is available on the TMHP Learning Management System (LMS) at the following link:
The video series can also be accessed on the TMHP YouTube channel at the following link:
Additional information related to PEMS is available on the TMHP website:
PEMS Portal Effective December 13, 2021
Providers should plan for the following changes on December 13, 2021:
- PEMS will replace Provider Enrollment on the Portal (PEP) and the Provider Information Management System (PIMS).
- PEP and PIMS will no longer be available.
- Paper applications for Texas Medicaid provider enrollment will be eliminated with the new online system.
- Providers must have access to the internet to utilize PEMS, and use up-to-date internet browsers for optimum performance of the PEMS portal. Use Google Chrome or Microsoft Edge to reduce compatibility issues.
Set up a TMHP Learning Management System (LMS) Account and a TMHP User Account
Providers should create TMHP accounts before enrollment transitions in December.
- Set Up a TMHP LMS Account: This is a provider education portal. The portal has important training on TMHP systems, setting up user accounts, and how to access and use PEMS. For instructions, refer to the Learning Management System (LMS) Registration and Navigation Job Aid for Providers.
- Set Up a TMHP User Account: To create a TMHP User Account, log in to the TMHP LMS and refer to the TMHP Portal Security Training Manual. The manual provides step-by-step instructions on activating and managing TMHP User Accounts.
The following educational materials will be available in early November 2021:
- TMHP Account Management Job Aid
- TMHP Portal Security Training Manual
- PEMS Best Practices Guide
- PEMS Computer-Based Training (CBT), which includes six modules:
- General Information
- New Enrollment
- Provider Management
For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.