Skip to main content

Texas Medicaid Provider Procedures Manual

Last updated on

The Texas Medicaid Provider Procedures Manual was updated on April 30, 2024, and contains all policy changes through May 1, 2024. The manual is available in both PDF and HTML formats.

Claim form examples referenced in the manual can be found on the claim form examples page.

See the release notes for a detailed description of the changes.

For previous editions of the manual, visit the manual archives.

May 2024 Texas Medicaid Provider Procedures Manual
Complete BookIndividual Chapters

Complete Book (HTML)

Complete Book (PDF)

Vol. 1 Preliminary Information
Vol. 1 Provider Enrollment and Responsibilities
Vol. 1 Texas Medicaid Fee-for-Service Reimbursement
Vol. 1 TMHP Electronic Data Interchange (EDI)
Vol. 1 Client Eligibility
Vol. 1 Fee-for-Service Prior Authorizations
Vol. 1 Claims Filing
Vol. 1 Appeals
Vol. 1 Third Party Liability (TPL)
Appendix A: State, Federal, and TMHP Contact Information
Appendix B: HIV/AIDS
Appendix C: Acronym Dictionary 
Ambulance Services Handbook
Behavioral Health and Case Management Services Handbook
Certified Respiratory Care Practitioner (CRCP) Services Handbook
Children's Services Handbook
Clinics and Other Outpatient Facility Services Handbook
Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook
Gynecological, Obstetrics, and Family Planning Title XIX Services Handbook 
Health and Human Services Commission Family Planning Program Services Handbook
Healthy Texas Women Program Handbook
Home Health Nursing and Private Duty Nursing Services Handbook
Inpatient and Outpatient Hospital Services Handbook
Medicaid Managed Care Handbook
Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook
Medical Transportation Program Handbook
Outpatient Drug Services Handbook
Physical Therapy, Occupational Therapy, and Speech Therapy Services Handbook
Radiology and Laboratory Services Handbook
School Health and Related Services (SHARS) Handbook
Telecommunication Services Handbook
Vision and Hearing Services Handbook