Medicaid

How to Get Credentialed with Texas Medicaid in Texas

Network: Open
30-90 Days

Quick Overview

Timeline

30 - 90 days

CAQH

Not Required

Re-credentialing

Every 5 year(s)

Delegated

No

Texas-Specific Requirements

Texas Medicaid (STAR/CHIP) enrollment steps: (1) Obtain NPI via NPPES. (2) Register through the HHSC (Health and Human Services Commission) portal managed by TMHP (Texas Medicaid & Healthcare Partnership) as fiscal agent. (3) Submit application with TX state license, proof of malpractice insurance, and required documentation. (4) Background check including DPS and federal criminal history is required for all providers. Texas operates managed care through multiple MCOs per service area under STAR, STAR+PLUS, STAR Kids, and STAR Health programs. Behavioral health providers accepted include LPC, LCSW, LMFT, and Licensed Psychologist with active Texas licensure; providers must enroll separately with each MCO. Revalidation is required every 5 years.

Medicaid Information — Texas

Agency: Texas HHSC

Program: Texas Medicaid

Portal: https://www.tmhp.com/topics/provider-enrollment

Phone: 1-800-925-9126

Step-by-Step Enrollment Process

1

Gather Required Documents

Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for Texas.

2

Prepare Your Application

Complete Texas Medicaid's provider enrollment application with all required information and supporting documentation.

3

Submit Your Application

Submit your completed enrollment package to Texas Medicaid.

4

Track & Follow Up

Credentialing typically takes 30-90 days. Monitor your application status and respond promptly to requests for additional information.

Required Documents Checklist

Background Check

Federal/state background check required for Medicaid enrollment

CV/Resume

Work history required

FINGERPRINT_CLEARANCE

Conditional

Required for some provider types

Fingerprinting required for some provider types

Malpractice Insurance

Conditional

Required in most states; some state programs waive for government employees

Medical License

NPI Certificate

Enrollment Forms

Texas Medicaid Provider Enrollment (TMHP)

Required
Online Open →

Contact Information

Provider Enrollment

National

1-800-925-9126

General Provider Inquiries

National

1-800-925-9126

Quick Links

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