New TMHP CLIA Laboratory Certification Web Page Now Available

Date: August 17, 2026

Attention: Providers

Call to action: The Texas Medicaid & Healthcare Partnership (TMHP) Required Clinical Laboratory Improvement Amendments (CLIA) Lab Certifications web page is now available on tmhp.com. Providers that perform laboratory services must comply with CLIA regulations and maintain the appropriate CLIA laboratory certification to receive Medicaid reimbursement.

How this impacts providers: HCPCS Procedure Codes Listed with Required CLIA Laboratory Certifications

• The Required CLIA Lab Certifications web page includes a link to the Healthcare Common Procedure Coding System (HCPCS) Certification Data spreadsheet.
  • This spreadsheet lists HCPCS procedure codes with their corresponding required CLIA laboratory certifications.
  • TMHP will regularly update the spreadsheet with the laboratory certifications that are required for each HCPCS procedure code as determined by the Centers for Medicare & Medicaid Services (CMS).

Important: Not every procedure code listed in the CLIA HCPCS Certification Data is a benefit of Texas Medicaid and other state health care programs. To verify whether a code is a benefit, refer to the Online Fee Lookup.

Updating CLIA Certification in PEMS

Providers can update their CLIA information in the Provider Enrollment and Management System (PEMS) through PEMS Maintenance – License transactions, PEMS Existing Enrollment transactions, or PEMS Revalidation transactions:

• If providers are disenrolled, they must update their CLIA information through a PEMS Reenrollment request.
• If providers are enrolled and outside of their revalidation window, they can update their CLIA information through a PEMS Maintenance or PEMS Existing Enrollment request.
• If providers are enrolled and within their revalidation window, they can update their CLIA information through a PEMS Revalidation application or, if they have not yet submitted a revalidation application, a PEMS Maintenance request. Providers that have already submitted a revalidation application cannot create a PEMS Maintenance request.

Next step for Providers: Providers should share this communication with their staff. Providers must update their CLIA information during their provider enrollment revalidation by providing the relevant information on the License/Certification/Accreditation tab in PEMS.

If you have any questions, please email Provider Relations at providerrelations@texaschildrens.org. 

For access to all provider alerts www.texaschildrenshealthplan.org/provideralerts.