Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, precertification, 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 “Provider Enrollment Revalidation Extensions to End on February 28, 2022,” which was posted on this website on November 1, 2021.
The Texas Health and Human Services Commission (HHSC) is reinstating the flexibility that extended revalidation dates due to the COVID-19 public health emergency (PHE).
Providers that were due for revalidation effective March 1, 2020, through November 30, 2022, will be given a post-PHE grace period to complete the revalidation process. TMHP will notify providers in August 2022 of their recalculated enrollment end date and again 120 days prior to their enrollment end date.
Providers who currently have revalidation applications in progress will be allowed to continue the application process and will receive a next revalidation due date based on the application results.
Providers who do not have revalidation applications in progress will be eligible to submit revalidation applications 120 days prior to their recalculated due date.
To submit for revalidation earlier than 120 days prior to the recalculated due date, email a request to email@example.com, and a provider relations representative will reach out to assist with the next steps.
Providers who were disenrolled due to failure to revalidate will be reactivated, and claims will be reprocessed based on the recalculated revalidation due date.
For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.