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.