WARNING: THIS IS A TEXAS HEALTH AND HUMAN SERVICES INFORMATION RESOURCES SYSTEM THAT CONTAINS STATE AND/OR U.S. GOVERNMENT INFORMATION. BY USING THIS SYSTEM YOU ACKNOWLEDGE AND AGREE THAT YOU HAVE NO RIGHT OF PRIVACY IN CONNECTION WITH YOUR USE OF THE SYSTEM OR YOUR ACCESS TO THE INFORMATION CONTAINED WITHIN IT. BY ACCESSING AND USING THIS SYSTEM YOU ARE CONSENTING TO THE MONITORING OF YOUR USE OF THE SYSTEM, AND TO SECURITY ASSESSMENT AND AUDITING ACTIVITIES THAT MAY BE USED FOR LAW ENFORCEMENT OR OTHER LEGALLY PERMISSIBLE PURPOSES. ANY UNAUTHORIZED USE OR ACCESS, OR ANY UNAUTHORIZED ATTEMPTS TO USE OR ACCESS, THIS SYSTEM MAY SUBJECT YOU TO DISCIPLINARY ACTION, SANCTIONS, CIVIL PENALTIES, OR CRIMINAL PROSECUTION TO THE EXTENT PERMITTED UNDER APPLICABLE LAW.
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AMA/ADA End User License Agreement
LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT® ")

You, your employees and agents are authorized to use CPT only as contained in materials on the Texas Medicaid & Healthcare Partnership (TMHP) website solely for your own personal use in directly participating in healthcare programs administered by THHS. You acknowledge that AMA holds all copyright, trademark and other rights in CPT.

Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the American Medical Association, Intellectual Property Services, 515 N. State Street, Chicago, Illinois, 60610. Applications are available at the American Medical Association website, www.ama-assn.org/go/cpt.

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This product includes CPT which is commercial technical data and/or computer databases and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer databases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.

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1. Subject to the terms and conditions contained in this Agreement, you, your employees and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of CDT is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights included in the materials.

2. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago IL 60611. Applications are available at the American Dental Association web site, http://www.ADA.org.

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EVV Impacts: Baylor Scott & White and FirstCare MCOs End Participation in Texas Medicaid Managed Care Effective Aug. 31

Last updated on 7/21/2026

Beginning Sept. 1, Baylor Scott & White and FirstCare will not participate in the STAR program and will no longer be available as managed care organizations (MCOs). Due to the termination of these health plans, the plan codes in the table below will be end-dated on Aug. 31, 2026.

Plan Code	Organization Name	Program Name	Service Delivery Area
50	FIRSTCARE	STAR	Lubbock
W4	FIRSTCARE	STAR	MRSA West
C3	S&W HP	STAR	MRSA Central

Members must choose another MCO in their service area to continue their services.

The following table lists existing MCOs and their applicable plan code that members, who are currently with Baylor Scott & White or FirstCare, can select to continue their services.

Plan Code	Organization Name	Program Name	Service Delivery Area
53	WELLPOINT	STAR	Lubbock
52	SUPERIOR	STAR	Lubbock
W2	WELLPOINT	STAR	MRSA West
W3	SUPERIOR	STAR	MRSA West
C1	WELLPOINT	STAR	MRSA Central
C2	SUPERIOR	STAR	MRSA Central

Payment of Services as of Sept. 1, 2026

Beginning Sept. 1, program providers, financial management services agencies (FMSAs), and Proprietary System Operators (PSOs) will have a new MCO payer plan code for their members who were served by Baylor Scott & White or FirstCare and must bill the new payer with dates of service on or after Sept. 1, 2026.

Program providers, FMSAs and PSOs using a third-party vendor for billing need to notify the third-party vendor about the changes.

Program Provider, FMSA and PSO Responsibilities

Program providers, FMSAs and PSOs should continue to use the current authorization in the Electronic Visit Verification (EVV) system for their members through Aug. 31, 2026.

For dates of service beginning Sept. 1, 2026, and after, program providers, FMSAs and PSOs should:

Identify the MCO and plan code that their member transitioned to.
Create a new authorization for the member, using the new MCO’s plan code and applicable information from the authorization that ends on Aug. 31.
Manually enter the member’s new authorization into their EVV system.

Program providers, FMSAs and PSOs can check their members’ eligibility and MCO assignment using one of the following methods:

The C21/SAVERR-based TMC EV and 270/271 eligibility inquiry is limited to access only current month eligibility information.
The EaaS/TIERS-based 270/271 or Medicaid Client Portal supports eligibility inquiry for future dates up to the end of the following month. Providers can use this to check eligibility.

Program providers, FMSAs and PSOs must continue to submit claims with EVV Required services directly to TMHP for EVV claims matching.

Contact

For more information about Baylor Scott & White and FirstCare ending participation with Texas Medicaid, email Managed_Care_Initiatives@hhs.texas.gov.

EVV Impacts: Baylor Scott & White and FirstCare MCOs End Participation in Texas Medicaid Managed Care Effective Aug. 31

Payment of Services as of Sept. 1, 2026

Program Provider, FMSA and PSO Responsibilities

Contact

Texas Medicaid Virtual Assistant