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Provider Enrollment on the Portal Instructions
Important: You must be enrolled in Traditional Medicaid before enrolling in CSHCN or Texas Health Steps. Select "Add to an Existing Enrollment," then click "Apply Filters" if you would like instructions for adding CSHCN or Texas Health Steps to your existing enrollment.
Page Filters
These pages will guide you through each stage of the enrollment process using PEP. To customize this page's content, use the filters below and click the Apply Filters button.

Application Type:

Program(s):

Enrolling As:

Payment Form

Instructions for Completing the Payment Form

Note: This page does not apply to Ordering and Referring Providers.

Note: This page does not apply to Individual or Performing Providers.

Note: This page does not apply to CSHCN, Texas Health Steps Medical, or Texas Health Steps Dental programs.

  • Section: Application Fee
  • Check the box to attest to one of the following three payment options:
  • I am submitting the application fee to Medicaid by paper check, money order, or cashier's check with this application.
    • If you have not already paid the application fee to Texas or another state, you must mail a check, money order, or cashier's check to Texas Medicaid after your application has been submitted. Cash cannot be accepted. Make the check or money order payable in the amount of $599. You will receive a Portal Ticket Number and a copy of the PEP Cover Letter after you submit this application. You must print it on the check or money order. You must include a printed copy of the PEP Cover Letter with the check. Mail the cover letter and check or money order to :

      • Texas Medicaid and Healthcare Partnership

      ATTN: Provider Enrollment

      PO Box 200795

      Austin, TX 78720-0795

  • I attest that I have already paid the application fee to Medicare or another state's Medicaid program or Children's Health Insurance Program, and I have been approved for enrollment in Medicare or another state's Medicaid program or Children's Health Insurance Program. My proof of payment and enrollment is attached to this application. I understand that if my proof of payment to Medicare or another state's Medicaid program or Children's Health Insurance Program is found to be unacceptable for any reason, I may be required to pay an application fee towards my Texas Medicaid enrollment application.
    • If you have already paid the application fee to Medicare or another state's Medicaid program or Children's Health Insurance Program, you must upload or submit a copy of your receipt as proof of payment. If you don't provide a copy of a receipt, you must pay the application fee.
  • I am requesting an application fee waiver due to financial hardship. My documentation that supports my request is attached to this application. I understand that I must submit a letter and supporting documentation with my enrollment application that specifies the reasons for which I am unable to pay an application fee. I understand that if the waiver request is denied, I will be required to submit an application fee if I want to proceed with the Texas Medicaid enrollment process.
    • If you think that you qualify for a hardship waiver, you can request one from Texas Medicaid. Texas Medicaid does not accept hardship waivers from other state Medicaid programs. You must upload or submit a letter that explains why you can't pay an application fee. You can also upload any documentation that you feel supports your case.
  • Click Continue and Save.
 
Contents
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