Oral Evaluation and Fluoride Varnish (OEFV) PEMS Reminder

Date: August 19, 2025

Attention: All Providers

Call to action: Texas Children Health Plan (TCHP) would like to remind providers to ensure their Oral Evaluation and Fluoride Varnish (OEFV) training certification is uploaded in Provider Enrollment and Management System (PEMS). TCHP has received a number of denials due to providers not including their certification on file. To help prevent these denials, providers are encouraged to upload their OEFV certification documentation in PEMS.

Where to update OEFV information in PEMS: Providers must ensure their OEFV certification is reflected in PEMS and update their OEFV certifications during their provider enrollment revalidation period in PEMS by clicking the License/Certification/Accreditation tab. Guidance is available at www.tmhp.com/topics/provider-enrollment/pems/licenses. 

OEFV in the Medical Home

• OEFV in the Medical Home offers limited services aimed at improving the oral health of children from 6 through 35 months of age.
• Eligible providers include Texas Health Steps enrolled physicians, physician assistants, and advanced practice registered nurses.

Training Certification

• Providers must first take an OEFV online training course offered by the Texas Health Steps to become certified to bill for this service. All other medical team members are encouraged to attend the training.
• Completion of this course does not certify you to bill Medicaid for oral evaluations and fluoride varnish. If you are a Physician, Physician's Assistant, or Advanced Practice Nurse and wish to receive certification to perform this service and bill Medicaid, you must also submit a certification application to Texas Health Steps.
• Take free Continuing Education (CE) courses through the Texas Health Steps Online Provider Education website. The OEFV course was developed by the Texas Health Steps Dental Program. The goal of the module is to introduce Texas Health Steps medical providers and other interested healthcare professionals to best practices for promoting oral health in children from 6 through 35 months of age.

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

Resources:

• Texas Medicaid Provider Procedures Manual(TMPPM), Children Services Handbook, section 4.3.13.1
• Oral Evaluation and Fluoride Varnish in the Medical Home (HHSC)
• Oral Evaluation and Fluoride Varnish CE/CME (Texas Health Steps)

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.