TMHP is aware that some newly issued Texas Medicaid patient control numbers (PCNs) appear as ineligible in certain TMHP systems. Providers that have a client with a Medicaid PCN that begins with a “9” should check the Medicaid Client Portal to verify eligibility.
This issue has an impact on some prior authorization requests and claims for affected clients.
Note: This issue does not impact Children with Special Health Care Needs (CSHCN) Services Program clients.
TMHP is actively working on this issue and will publish a follow‑up article on TMHP.com/News when the issue is resolved.
Prior Authorization and Claims:
TMHP has provided specific instructions related to prior authorization requests, claims submissions, and timeliness requirements for clients with affected PCNs. Guidance differs based on service type and whether the client is fee‑for‑service or managed care.
Providers are strongly encouraged to review the full TMHP PCN Provider Notice for complete details and instructions.
Providers are encouraged to share this information with their staff. If you have any questions about this notice, please email Provider Relations at ProviderRelations@cfhp.com or call 210-358-6030. You can also contact your Provider Relations Representative directly.
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