Reminder: Requirements for Provider Enrollment Revalidation

Date: September 3, 2025

Attention: All Providers

Subject: Reminder: Requirements for Provider Enrollment Revalidation

Call to action: Texas Children’s Health Plan (TCHP) would like to remind providers that they must complete their revalidation enrollment before their current enrollment period ends. Provider revalidation requests must be in “closed-enrolled” status to be considered complete.

Providers can revalidate their enrollment in PEMS up to 180 calendar days before their revalidation due date. For more information, visit the How to Apply for Enrollment page on tmhp.com, click on Determine Your Application Type, and scroll to the Revalidation heading. In regards to enrollment revalidation timelines, providers can also refer to TMHP’s provider notification: Providers to Receive Second Revalidation Due Date Extension.

Important: The Texas Medicaid & Healthcare Partnership (TMHP) will disenroll providers from all Texas state health care programs if they fail to complete the revalidation process by their deadline. TMHP will also deny all claims and prior authorization requests.

Note: Providers that are revalidating should continue to submit claims to ensure that they meet timely filing requirements.

Documentation

Revalidating providers may need to provide fingerprints, submit additional documentation, or complete other screening requirements. To avoid delays, have the following information ready:

First and last name
Organization name
Social Security number
Date of birth
Employer Identification Number (EIN) and legal name
Licenses or certifications, if applicable
Documentation related to disclosures, if needed
Additional documentation required for program participation
Identification for the provider and any person who meets the definition of owner, creditor, principal, subcontractor, or managing employee

Note: For more information about “identification for the provider and any person who meets the definition of owner, creditor, principal, subcontractor, or managing employee,” providers may refer to these resource documents:

Application Fee

Some revalidating providers must pay an application fee. Refer to the document titled State of Texas Provider Types Required to Pay an Application Fee for details about which institutional providers need to pay the application fee.

Providers can refer to the Texas Medicaid Provider Procedures Manual (TMPPM), “Section 1, Provider Enrollment and Responsibilities” for information about enrollment requirements.

Next steps: Providers should share this communication with their staff.

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

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