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FQHC and RHC New Provider Types for Telemonitoring Services Will Be Available in PEMS

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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.

Effective September 1, 2024, pursuant to House Bill 2727, 88th Regular Legislative Session, 2023, federally qualified health center (FQHC) and rural health clinic (RHC) providers will be added as providers of home telemonitoring services to Texas Medicaid.

Upon enrollment in the Provider Enrollment and Management System (PEMS), these provider types will be authorized to provide and be reimbursed for home telemonitoring services.

The new FQHC and RHC provider types will be able to attest in PEMS on new enrollment, revalidation, reenrollments, and existing enrollments for home telemonitoring services.

PEMS Updates

A new “PEMS Maintenance - Practice Location - Attestation & Home Telemonitoring" request type will be available for providers to make a selection under the Programs and Services Participation Details sub-page in PEMS.

FQHC and RHC providers will go to the “Program Specific Questions” section of the page and answer Yes or No to the question, “Do you offer home telemonitoring services?” After selecting an answer, click SAVE at the bottom of the page.

Providers can refer to the PEMS Instructional Site for additional guidance on completing their enrollment.

Providers may refer to the current Texas Medicaid Provider Procedures Manual, Volume 2, Telecommunication Services Handbook, section 3.6, “Telemonitoring Services,” for additional information.

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