Please update your enrollment and demographic information with TMHP (Texas Medicaid Healthcare Partnership). TMHP is HHSC’s provider enrollment administrator and serves as the authoritative source for HHSC providers’ enrollment and demographic information. Once you update your enrollment and demographic information with TMHP, your data will be reconciled with the demographic information on file with the MCOs. The TMHP Provider Enrollment webpage can be accessed at the following URL: https://www.tmhp.com/topics/provider-enrollment
To make updates to your current enrollment (e.g., new practice locations or change of ownership updates), please access the Provider Enrollment and Management System (PEMS) web page at the following URL: https://secure.tmhp.com/pems.
The Step-by-Step Guide can be accessed at the following URL: https://www.tmhp.com/topics/provider-enrollment/pems/start-application
This page includes step-by-step instructions for maintenance requests as well as new enrollment, existing enrollment, revalidation, and reenrollment. Select the link under Existing Enrollment to access instructions for adding new practice locations or to submit a change of ownership. Select the link under Maintenance to access instructions for updating demographic data. This page also provides links to the Enrollment Help page and the TMHP YouTube channel.
TCHP will contract, credential and pay only those providers who are properly enrolled with TMHP and whose information is received in the official PEMS file from TMHP. In addition, it is important that every provider be enrolled at each location where they see patients. This will help ensure claims process correctly and an accurate online provider directory for our Members seeking care.
Clinical Laboratory Improvement Amendments (CLIA) Certification
Providers that perform or bill for laboratory services must maintain a valid CLIA certification in PEMS.
CLIA certification:
- Must be current and accurate in PEMS
- Must be appropriate for each laboratory procedure code billed
Claims submitted for laboratory services without the appropriate CLIA certification on file in PEMS may be flagged or denied in accordance with Texas Medicaid requirements.
Providers are strongly encouraged to:
- Regularly review CLIA information in PEMS
- Update CLIA certifications when adding new services or locations
- Ensure CLIA information is accurate during enrollment maintenance and revalidation
To view the Provider Alerts related to PEMS, visit our Provider Alerts page and search PEMS.
