Date: March 4, 2025
Attention: Providers
Update as of 7/8/2025: The Texas Medicaid & Healthcare Partnership (TMHP) and the Texas Health and Human Services Commission (HHSC) have extended the revalidation due dates and enrollment period gap closure flexibilities to November 30, 2025. Providers that have started the revalidation or reenrollment process should complete applications and address any outstanding deficiencies as soon as possible to minimize any delays or challenges. Providers that have not yet begun the revalidation process should start as soon as possible. Providers can start the revalidation process 180 calendar days before their revalidation due date. HHSC is providing additional flexibility for providers that have already received a revalidation due date extension. Beginning July 8, 2025, providers that have already received a 180-calendar day revalidation due date extension will be eligible for a second 180-calendar day extension if they do not complete revalidation by their revised due date. The second revalidation due date extension will be visible in the Provider Enrollment and Management System (PEMS) on the Provider Information page. |
Call to action: This information is for providers that have not taken action and revalidated their enrollment information. As a reminder, providers must complete their revalidation enrollment before the end of their enrollment period. Providers can revalidate their enrollment in the Provider Enrollment and Management System (PEMS) up to 180 calendar days before their current revalidation due date.
Revalidation is conducted within the Texas Medicaid and Healthcare Partnership (TMHP) website at tmhp.com/topics/provider-enrollment/how-apply-enrollment under “Determine Your Application Type”.
How this impacts providers: There are serious consequences if providers do not respond timely. Providers that do not complete the revalidation process by their deadline will be disenrolled from all Texas state health care programs, and claims and prior authorization requests will be denied.
Resource: Texas Medicaid Provider Procedures Manual, Vol. 1, Provider Enrollment and Responsibilities
Provider Requirements
Revalidating providers may need to provide fingerprints, submit additional documentation, or complete other screening requirements.
Providers may view and confirm their revalidation date and enrollment information in PEMS. To reduce application time, we encourage providers to have the following information available:
- First and last name
- Organization name
- Social Security number
- Date of birth
- Employer’s Tax Identification Number and legal name
- Licenses or certifications, if applicable
- Identification for the provider and any person who meets the definition of owner, creditor, principal, subcontractor, or managing employee
- Documentation related to disclosures, if needed
- Additional documentation required for program participation
Providers revalidating an existing enrollment should continue to submit claims to meet their timely filing requirements.
Application Fee
Certain revalidating providers must pay an application fee. Refer to the State of Texas Provider Types Required to Pay an Application Fee to determine which institutional providers must pay the provider enrollment application fee.
Next step for Providers: Providers must take action and adhere to the revalidation requirements by the end of their enrollment period.
Resource: Webinars on Revalidation Due Date Extension and Retroactive Enrollment Period Effective Dates. Click here for more information.
If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org.
For access to all provider alerts: https://www.texaschildrenshealthplan.org/providers/provider-news/provider-alerts.
