Date: July 24, 2025
Attention: Providers
Effective date: September 1, 2025
Call to action: The purpose of this communication is to make providers aware that on September 1, 2025, the Texas Medicaid & Healthcare Partnership (TMHP) will update telemedicine information in the following subsections of the Texas Medicaid Provider Procedures Manual (TMPPM), Telecommunication Services Handbook:
On September 1, 2025, the Texas Medicaid & Healthcare Partnership (TMHP) will update telemedicine information in the following subsections of the Texas Medicaid Provider Procedures Manual (TMPPM), Telecommunication Services Handbook:
- Subsection 3.1, “Patient Health Information Security”—TMHP will remove the reference to the requirement stating that a health professional must be present with the child for school-based telemedicine.
- Subsection 3.4.1, “Distant Site”—TMHP will remove the reference to out-of-state physicians to align with the recently amended Texas Administrative Code (TAC) rules relating to telemedicine services.
- Subsection 3.4.2.1, “Prescriptions Generated from a Telemedicine Medical Service”—TMHP will update the TAC rule references for the treatment of clients with acute pain and compliance requirements for prescriptions issued through a telemedicine service.
Link to Texas Medicaid Provider Procedures Manual: https://www.tmhp.com/resources/provider-manuals/tmppm
Texas Medicaid managed care organizations (MCOs) like Texas Children’s Health Plan must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO/TCHP. Administrative procedures, such as prior authorization, precertification, referrals, and claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should reference a member’s specific MCO/TCHP for information on these items. For TCHP, this information can be found on the provider page available here https://www.texaschildrenshealthplan.org/providers.
Next step for Providers: 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: www.texaschildrenshealthplan.org/provideralerts.
