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Important Update Actualización importante:

Good news! All CHIP, STAR, and STAR Kids Member Handbooks are now available online. Quick, easy access to your benefits and coverage information - any time!

¡Buenas noticias! Todos los manuales para miembros de CHIP, STAR y STAR Kids ya están disponibles en línea. Obtén acceso rápido y sencillo a la información sobre tus beneficios y cobertura, ¡en cualquier momento!

Medicaid Preferred Drug List and Formulary Changes Cambios en el formulario y la lista de medicamentos preferidos de Medicaid

The Vendor Drug Program (VDP) made changes to the Texas Medicaid drug formulary effective July 24, 2026. To learn more about formulary changes impacted, please click here for more information.

El programa de medicamentos de proveedores de Texas (VDP) ha realizado cambios recientes en el formulario de medicamentos de Medicaid de Texas. Esto entrará en vigencia el 24 de julio de 2026. Para obtener más información sobre los cambios en el formulario afectados, visite el siguiente enlace para obtener más información.

Therapy Provider Enrollment Clarification

Date: August 21, 2025

Attention: Therapy Providers

Call to action: The purpose of this communication is to clarify Provider Enrollment and Management System (PEMS) enrollment for therapy providers. Specifically, Texas Children’s Health Plan (TCHP) would like to focus on Comprehensive Care Program (CCP) and non-CCP program. This message is in accordance with guidance provided in the Texas Medicaid Provider Procedures Manual (TMPPM).

How this impacts providers:

Certain provider types must enroll as an individual in PEMS.

CCP Program Enrollment: Individual Enrollment Required

  • Physical Therapy
  • Occupational Therapy
  • Speech-Language Pathologists

Non- CCP Enrollment: Individual Enrollment Required

  • Physical Therapy
  • Occupational Therapy

Non-CCP Enrollment: Performing or Individual Enrollment Required

  • Speech-Language Pathologists

Physical and occupational therapists, speech-language pathologists, and registered nurses in the Comprehensive Care Program (CCP) must enroll as individuals.

Resources:

TMPPM: Section 1.1.4 Provider Enrollment Identification

TMPPM: Section 6: Claims Filing

Provider Alerts:

July 2025: Clarification and TMPPM Update: CCP Therapists and Registered Nurses Must Enroll as Individuals | Texas Children's Health Plan

March 2025: Provider Enrollment and Management System (PEMS) Reminders | Texas Children's Health Plan

Next step for Providers: Providers must adhere to the guidance provided by TMPPM and outlined in this communication. For more information, view a new PEMS and Revalidation video available here. There is also the Provider Enrollment Requirements page with all of the resources listed.


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

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