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Update to Article “Provider Enrollment Revalidation Extensions to End”

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Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO. Administrative procedures, such as prior authorization, precertification, referrals, and claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the member’s specific MCO for details.

This is an update to the article titled “Provider Enrollment Revalidation Extensions to End,” which was published on this website March 10, 2023.

The Centers for Medicare & Medicaid Services (CMS) and the Texas Health and Human Services Commission (HHSC) have issued a post-public health emergency (PHE) update extending the grace period for providers with revalidation due dates from May 12, 2023, through November 11, 2023.

Providers will receive a six-month extension if their revalidation due date falls within this timeframe. Additionally, no enrollment gaps will occur during the post-PHE grace period. Providers can find their recalculated revalidation due dates on the Provider Information page in the Provider Enrollment and Management System (PEMS).

Providers with an application in progress may cancel their application and resubmit later, or they may choose to continue the application to avoid enrollment delays at the end of the grace period.

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