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Adding Practice Locations in PEMS

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Action Required: Practice Location Update for HCS Providers

If you are a Home and Community-based Services (HCS) provider that has been notified by the Texas Medicaid & Healthcare Partnership (TMHP) that you need to complete your Texas Medicaid revalidation through the Provider Enrollment and Management System (PEMS), it is important to confirm the accuracy of your provider enrollment details.

Failure to update your enrollment record as required could result in payment recoupment, termination from Medicaid, or other adverse actions.

For all Medicaid enrollments, including new enrollments, revalidations, and reenrollments, HCS program providers must disclose, confirm, and maintain correct information regarding all practice locations in PEMS.

What Is Considered a Practice Location? 

Each distinct physical location where services are provided, even if operated by the same health care entity or provider, is typically considered a separate practice location. This includes satellite offices, clinics, or any other facilities. A practice location typically has a specific physical address where health care services are delivered. This address is used for enrollment and verification purposes. For HCS providers, this includes all billing and administrative office locations, three-person residences, four-person residences, and host home/companion care (HH/CC) residences.

How To Add a Practice Location

The How to Add Practice Locations in PEMS job aid includes detailed steps on how to complete practice location requirements or add a location if it is not already on file in PEMS.

Site Visits

As part of the standard revalidation process, TMHP will conduct a site visit at each practice location listed in your HCS enrollment record. These site visits are federal requirements under the Affordable Care Act (ACA) for providers categorized as moderate or high risk, including HCS providers. Site visit coordinators will schedule visits using the phone number listed in the Basic Information tab in PEMS for each practice location.

Site visits are required to be conducted before the enrollment request is complete. However, some revalidation applications may be conditionally approved prior to the completion of all site visits due to a temporary waiver granted by the Texas Health and Human Services Commission (HHSC).

Refer to the ACA Screening Requirements resource for additional site visit details.

Site visits will be conducted at:

  • Any billing or administrative office locations listed in your enrollment record.
  • All HCS practice locations associated with your National Provider Identifier (NPI).
  • Any non-HCS practice locations associated with your enrollment record.

All practice locations will need to have the following required documents on hand for review during the site visit. Use current versions of these documents (possibly from HCS billing and administrative office locations) once a site visit has been scheduled.

  • Personnel listing or organizational chart (including titles)
  • Assumed name certificate or “Doing Business As” certificate
  • Complaint policy log

Helpful Resources

For assistance with revalidation or adding additional practice locations, providers should email the TMHP Provider Relations department at provider.relations@tmhp.com. A provider representative can schedule an enrollment walkthrough to answer questions and assist in completing the revalidation steps.

For more information on the revalidation processes, refer to the following TMHP training resources: