PAYER READY CREDENTIALING & COMPLIANCE
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

Who Runs Texas Medicaid Provider Enrollment

50-state research

Enrollment Portal

PEMS (Provider Enrollment and Management System) via TMHP

Operated By

Accenture (TMHP)

Platform

PEMS

Texas is the only state where Accenture runs Medicaid enrollment, through the TMHP organization and its PEMS system, so Texas specific guidance rarely transfers to other states.

Go to the official Texas enrollment portal

From PayerReady's 50-state Medicaid enrollment platform research, verified July 2026. Portal contracts change; where an operator is in transition or not publicly confirmed, we say so rather than guess.

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.

Free Consultation

Need help enrolling with Texas Medicaid?

Our specialists handle the entire Texas Medicaid enrollment process: applications, follow-ups, and approvals in Texas.

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 →

Key Credentialing Terms

Capitation
A payment model where a payer pays a provider a fixed amount per member per month regardless of whether the member recei...
CAQH
The Council for Affordable Quality Health Care, an organization that maintains a universal provider database (CAQH ProVi...
Credentialing
The process of verifying a healthcare provider's qualifications, training, licensure, and professional background to ens...
Effective Date
The date on which a provider's enrollment or network participation becomes active, allowing them to begin billing a paye...
Managed Care
A healthcare delivery system organized to manage cost, utilization, and quality through techniques such as provider netw...
Network Adequacy
The requirement that a health plan's provider network has enough providers in each specialty and geographic area to give...
NPI
The National Provider Identifier is a unique 10-digit identification number issued by CMS to healthcare providers, requi...
Primary Source Verification
The process of verifying a provider's credentials directly from the original issuing source, such as medical schools, li...

Credentialing Checklist

Make sure you have everything ready before applying to Texas Medicaid.

View Physician Credentialing Checklist →

Contact Information

Provider Credentialing

National

1-800-925-9126

Mon-Fri 8am-5pm

Provider Services

National

1-800-925-9126

Claims & Billing

National

1-800-925-9126

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Reviewed by the PayerReady Credentialing Team

Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.

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