Information posted June 21, 2016
LTSS providers must re-enroll each unique National Provider Identifier (NPI) in one of the following three ways:
- LTSS providers that bill through Texas Medicaid & Healthcare Partnership (TMHP) for Acute Care services (including crossover claims for dual eligible clients) must reenroll through TMHP. If you do not know whether you bill TMHP, contact TMHP Contact Center at 1-800-925-9126 and have your NPI readily available.
- LTSS providers that bill Long Term Care claims only through TMHP and have an active Medicaid contract with Texas Department of Aging and Disability Services (DADS) must enroll or re-enroll through DADS.
- LTSS providers that bill Medicaid Managed Care Organizations (MCOs) only must re-enroll through the HHSC Medicaid/CHIP Division (MCD) MCO LTSS process. See information below for additional details.
If a provider submitted a completed application to TMHP or DADS and has a pending enrollment, the provider does not need to submit any additional information.
Note: If your NPI is already successfully re-enrolled through TMHP or DADS, that specific NPI is considered Patient Protection and Affordable Care Act (PPACA) compliant. Any additional NPIs that are enrolled with either TMHP or DADS will need to be re-enrolled.
Information for Medicaid Managed Care Organization Billing Only LTSS Providers
There is a separate enrollment process for Medicaid MCO LTSS providers that bill MCOs only. These providers do not have an active Texas Provider Identifier (TPI) for the same provider type to bill TMHP for acute care services and do not have an active DADS Medicaid contract.
These providers are required to re-enroll through the HHSC Medicaid/CHIP Division (MCD) MCO LTSS provider re-enrollment process.
Medicaid MCO LTSS providers must contact the HHSC MCD MCO LTSS Provider Reenrollment mailbox at MCO_LTSS_Provider_Re-Enrollment@hhsc.state.tx.us to request the HHSC MCD MCO LTSS Provider Re-enrollment Application and additional information about the MCO LTSS provider re-enrollment process.
Clarification on Nursing Facility Re-enrollment
Nursing facilities that serve Medicare/Medicaid dual eligible clients should re-enroll with TMHP for crossover claims processing. If a provider has already re-enrolled with DADS, TMHP will honor DADS re-enrollment and no further action is required.
Re-enrollment Resources for LTSS Providers
Additional information about DADS re-enrollment is located on the DADS Re-enrollment webpage.
Additional information about TMHP re-enrollment is located on the TMHP Provider Reenrollment webpage.
To obtain the MCO LTSS Provider Re-enrollment application or ask questions about the process, send an email to: MCO_LTSS_Provider_Re-Enrollment@hhsc.state.tx.us. For more information, call the TMHP Contact Center at 1-800-925-9126.