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Notices for Providers

Hurricane Harvey Update

Effective August 25, 2017, Pharmacy and Provider copays will be waived for members in the FEMA declared disaster counties.

Visit HHSC's website Hurricane Harvey Information for Providers

Updated - Hurricane Harvey Medicaid and Children's Health Insurance Program (CHIP) Frequently Asked Questions for Managed Care Organizations (MCOs)

Medicaid Fraud Notice


Adoption Assistance

Effective 09/01/2017 Adoption Assistance members are required to enroll in managed Medicaid and will be new members with Texas Children’s Health Plan STAR or STAR Kids programs.

Provider Alert: Adoption Assistance

STAR Kids Billing Matrix

The STAR Kids billing matrix has been updated to include the registered nurse modifier (TD) to the private duty nursing (PDN) billing code, T1000. Additionally, the billing codes for PDN independently enrolled LVNs and RNs have been added to the matrix. The Revenue Code 663 was added to the Out-of-Home Respite codes. Attached is the updated billing matrix, which will be added to the handbook. This billing matrix will become effective on June 5, 2017.


June 5, 2017 Billing Matrix

LTSS Billing Procedures

STAR Kids Handbook

Long Term Care Provider Bulletin, No. 69

Contact Provider Relations

Effective April 1: EVV Compliance Score Must be 90%

Beginning April 1, 2017, providers required to use Electronic Visit Verification (EVV) will be required to meet the minimum EVV compliance score of 90% as outlined in the EVV Provider Compliance Plan. Providers were required to meet the minimum score of 75% for the first year of compliance from April 1, 2016, through March 31, 2017. Questions about this alert can be sent to:

Texas Health Steps Regional Representative Contact List

Click for THSteps Regional Provider Relations Representatives

THSteps Documentation Improvement

As a Texas Health Steps (THSteps) provider, you affect the lives of many young Texans, and the Health and Human Services Commission (HHSC) understands documenting the THSteps components of the checkup can be challenging. One federal and two state contracted reviews of medical records have shown that missing documentation is the largest factor and the primary cause of records being reviewed and money being recouped. HHSC would like to assist you in documenting all of the required components and elements of the THSteps checkups in order to reflect the work you perform to complete each checkup. | read more...

Patient Protection And Affordable Care Act Deadline Has Passed And Dis-enrollment From Texas Medicaid Will Occur January 31, 2017

The Patient Protection and Affordable Care Act (PPACA) requires providers to have revalidated their enrollment in state Medicaid programs by September 24, 2016. In accordance with PPACA and based on direction from the Texas Health and Human Services Commission (HHSC),TMHP has accepted and is processing completed revalidation applications received by September 24, 2016. | read more...   

THsteps Checkup Documentation -- Essential to Medical Records

As a Texas Health Steps (THSteps) provider you affect the lives of many young Texans. The care you provide helps prevent serious or chronic health-care problems and often helps young patients begin to develop positive lifelong health-care habits. Being a THSteps provider can be very rewarding. It can also be very challenging, especially when it comes to medical checkup documentation. | read more...