Provider News
Prior Authorizations Extended for Services Impacted by 2025 Texas Flooding
UPDATED 9/3/2025: This news post has been edited to reflect updated guidance from HHSC. The information below applies to all Texas Medicaid clients impacted by the 2025 Texas flooding regardless of whether the clients are permanent residents of a declared disaster...
Rider 32 Update: EVV Required for Medicaid-Only Services for Dual Eligible Members
Beginning Sept. 1, the Texas Health and Human Services Commission (HHSC) will transition Medicaid-only services for dually eligible clients (clients who are eligible for both Medicare and Medicaid) enrolled in Medicaid managed care from a fee-for-service (FFS) to a...
Reimbursement Update for High-Cost Clinician-Administered Drugs (HCCADs)
Inpatient high-cost clinician-administered drugs (HCCADs) are drugs or biologics that the Texas Health and Human Services Commission (HHSC) has approved to be “carved out” of the All-Patient Refined Diagnosis Related Group (APR-DRG) and can be billed on an outpatient...
Payspan Portal Production Maintenance – Saturday, August 16, 5:00 P.M. (ET) through 8:00 P.M. (ET)
Dear Valued Zelis® Customer: Zelis® is utilizing a maintenance window for the Payspan Portal from 5:00 P.M. (ET) – 8:00 P.M. (ET) on Saturday, August 16, 2025. Note: We will end the maintenance early if the activities are completed by 8:00 P.M....
THSteps Newborn Screening – Key Reminders for Providers
Community First Health Plans would like to remind providers of the THSteps newborn screening requirements and related billing guidance for Medicaid-enrolled infants. Under the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT), newborn screenings are a...
Inactive TMHP User Accounts to Be Deactivated Starting August 11, 2025
Starting August 11, 2025, Texas Medicaid & Healthcare Partnership (TMHP) Provider accounts that have been inactive for a period of two years or more will be deactivated. Providers must log in to their accounts or change their passwords every 90 days to avoid...
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