Instructions for Completing the Programs Section
Instructions for Reviewing the Programs Page
Select the Application Type from the left navigation menu.
Eligible Program.
Verify the information on file is accurate. If you require any edits, make the appropriate updates.
Eligible programs will appear based on your National Provider Identifier (NPI) type and eligible taxonomies. After programs have been selected at the NPI level, you will then be required to associate which programs pertain to each of your practice locations.
Section: Program
Acute Care-Fee-for-Service—Click Yes or No.
Formerly known as Traditional Medicaid.
Acute Care – Comprehensive Care Program (CCP) – Select Yes or No.
CCP providers must meet Medicaid and Health and Human Services Commission (HHSC) participation standards to enroll in the program. All CCP providers must be enrolled in Texas Medicaid to be reimbursed for services.
Acute Care—Texas Health Steps Dental—Click Yes or No.
Under the Early Periodic Screening Diagnostic, and Treatment (EPSDT) regulation, known in Texas as Texas Health Steps (THSteps), Section 1905(r) of the Social Security Act mandates that all people who are eligible for Medicaid and birth through 20 years of age receive medically necessary services to treat, correct, and ameliorate illnesses and conditions identified if the service is covered in the state’s Medicaid plan or is an optional Medicaid service.
Acute Care—Texas Health Steps Medical—Click Yes or No.
The Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) service is Medicaid’s comprehensive preventive child health service for clients who are birth through 20 years of age. In Texas, EPSDT is known as Texas Health Steps (THSteps) and includes periodic screening, vision, hearing, and dental preventive and treatment services. EPSDT was created by the 1967 amendments to the federal Social Security Act and defined by the Omnibus Budget Reconciliation Act (OBRA).
Acute Care—Case Management—Click Yes or No.
Case management services are provided to help Medicaid eligible persons gain access to necessary medical, social, educational, and other services. Case managers assess a person’s need for services and develop a service plan to address needs.
Children with Special Health Care Needs (CSHCN) Services Program– Select Yes or No.
The Children with Special Health Care Needs (CSHCN) Services Program is the oldest governmentally-administered continuous medical assistance program in Texas for low-income children with special health-care needs and people of any age with cystic fibrosis. The program currently receives part of its funding from Title V, and aligns its services with Title V objectives.
CSHCN-Family Support Services (FSS) – Select Yes or No.
Family Support Services are services that help families take care of Children with Special Health Care Needs Services Program clients at home. These services can also help a client be more independent and able to take part in family life and community activities.
Medical Transportation Program (MTP) –Select Yes or No.
The Medical Transportation Program (MTP), under the direction of the Texas Health and Human Services Commission (HHSC), arranges nonemergency medical transportation services and travel-related services for eligible fee-for-service (FFS) Medicaid, Children with Special Health Care Needs (CSHCN) Services Program, and Transportation for Indigent Cancer Patients (TICP) clients who have no other means of transportation.
Managed Care Organization – Long Term Support Services program – Select Yes or No.
A Managed Care Organization (MCO) Long Term Support Services (LTSS) provider is any provider who provides LTSS services under a specific National Provider Identifier (NPI) and taxonomy combination, and submits claims through Medicaid Managed Care.
Pharmacy Services– Select Yes or No.
The Texas Vendor Drug Program provides statewide access to covered outpatient drugs for people enrolled in Texas Medicaid Programs.
Kidney Health Care – Select Yes or No.
Kidney Health Care is a statewide program that helps Texans with end-stage renal disease pay for their treatment.
Children’s Health Insurance Program (CHIP) – Select Yes or No.
CHIP covers children in families that earn too much money to qualify for Medicaid but cannot afford to buy private insurance.
Medicare Only – Select Yes or No.
You must have a current and active Medicare enrollment in order to enroll as a Texas Medicaid Medicare-Only provider. Providers enrolled as Medicare Only are not able to submit claims for payment to Texas Medicaid.
Click Save.
Access the left navigation and select the next available page to continue entering your application.
Click Save.
Access the left navigation and select the next available page to continue entering your application.
This page is not applicable for Performing Provider enrollments. Please continue to the next page.
Instructions for Completing the Programs Section
Eligible Program.
After programs have been selected at the NPI level, you will then be required to associate which programs pertain to each of your practice locations.
Section: Program
Acute Care-Fee-for-Service—Click No.
Formerly known as Traditional Medicaid.
Acute Care – Comprehensive Care Program (CCP) – Select No.
Acute Care—Texas Health Steps Dental—Click No.
Acute Care—Texas Health Steps Medical—Click No.
Acute Care—Case Management—Click No.
Children with Special Health Care Needs (CSHCN) Services Program– Select No.
CSHCN-Family Support Services (FSS) – Select Yes or No.
Medical Transportation Program (MTP) –Select No.
Long Term Support Services program – Select No.
Pharmacy Services– Select No.
Kidney Health Care – Select No.
Medicare Only – Select No.
Click Save.
Access the left navigation and select the next available page to continue entering your application.