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Reminder: Provider Enrollment Revalidation Requirements

Last updated on 3/1/2022

Reminder: Providers must complete their revalidation enrollment before the end of their enrollment period. Providers can revalidate their enrollment in the Provider Enrollment and Management System (PEMS) up to 120 calendar days before their current revalidation due date.

Providers may find more information and start their revalidations in PEMS through the TMHP.com website at https://www.tmhp.com/topics/provider-enrollment/how-apply-enrollment under “Determine Your Application Type.”

Providers that do not complete the revalidation process by their deadline will be disenrolled from all Texas state health-care programs; claims and prior authorization requests will be denied.

Provider Requirements

Revalidating providers may need to provide fingerprints, submit additional documentation, or complete other screening requirements.

Providers may view and confirm their revalidation date and enrollment information in PEMS. To reduce application time, we encourage providers to have the following information available:

  • First and last name
  • Organization name
  • Social Security number
  • Date of birth
  • Employer’s Tax Identification Number and legal name
  • Licenses or certifications, if applicable
  • Identification for the provider and any person who meets the definition of owner, creditor, principal, subcontractor, or managing employee
  • Documentation related to disclosures, if needed
  • Additional documentation required for program participation

Providers revalidating an existing enrollment should continue to submit claims to meet their timely filing requirements.

Certain revalidating providers must pay an application fee. Refer to the State of Texas Application Fee Requirement by Provider Service to determine which institutional providers must pay the provider enrollment application fee.

Providers can also refer to the current Texas Medicaid Provider Procedures Manual, General Information, Vol. 1, “Provider Enrollment and Responsibilities,” for more information.

For more information, call the TMHP Contact Center at 800-925-9126.