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Kidney Health Care and Children With Special Health Care Needs – Family Support Services Texas Medicaid Provider Enrollment

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This article has been updated. For the updated information, click here.

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.

Effective August 15, 2022, providers can now enroll in the Kidney Health Care (KHC) and Children with Special Health Care Needs – Family Support Services (CSHCN-FSS) programs through the Texas Medicaid & Healthcare Partnership (TMHP) Provider Enrollment and Management System (PEMS).

Provider enrollment functions are available through PEMS, and providers must use this new system to enroll in Texas Medicaid.

The new system is the single tool for provider enrollment, reenrollment, revalidation, change of ownership, and maintenance requests (maintaining and updating provider enrollment record information).

Texas Medicaid Provider Enrollment

TMHP will enroll the following provider types for the KHC and CSHCN-FSS programs:

KHC Providers:

  • Ambulatory surgical center (ASC)
  • Certified registered nurse
  • Clinic/Group practice
  • Hospital – In state
  • Hospital – Out of state
  • Hospital – Military
  • Hospital – Transplant
  • Hospital ambulatory surgical center (HASC)
  • Physician (MD/DO)
  • Prescription drug program
  • Renal dialysis facility (freestanding)
  • Renal dialysis facility (hospital based)

CSHCN-FSS Providers:

  • Respite care
  • Home modifications
  • Home inspectors
  • Vehicle modifications

PEMS Instructional YouTube Videos

TMHP has developed a series of instructional how-to videos that detail the steps required to update provider enrollment records.

To view the completed series of instructional how-to videos, click here.

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.