Provider News
Reminder: Laboratory Services Require Updated CLIA Certification in PEMS
Attention all Laboratory Providers! Effective November 1, 2025, all Providers that submit claims for laboratory processes/procedures that require CLIA licensure must ensure their CLIA licensure and certification code(s) information is updated in the TMHP PEMS...
Update to RSV Vaccine Age Restrictions – Effective June 25, 2025
Community First Health Plans would like to inform providers of an important update to Texas Medicaid coverage for the respiratory syncytial virus (RSV) vaccine. Effective June 25, 2025, the age range limitations for RSV vaccine procedure codes 90679 and 90683 have...
Healthy Texas Women (HTW) 2026 Recertification Period Begins November 1, 2025
Healthy Texas Women (HTW) providers who intend to provide or continue providing HTW services during program year 2026 (January 1, 2026 – December 31, 2026) must complete the annual recertification process. The recertification window for the 2026 program year will be...
House Bill 44 and Provider Responsibilities Regarding Immunizations
The purpose of this communication is to inform providers of new state requirements under House Bill (H.B.) 44 (88th Legislature, Regular Session, 2023). Effective April 29, 2025, the Texas Health and Human Services Commission (HHSC) adopted new rules that prohibit...
ProgenyHealth Provider Training Resource for UM and Case Management
On September 24, 2025, ProgenyHealth hosted a virtual training session for Community First Health Plans Providers to introduce the new utilization management process for STAR Medicaid NICU admissions and case management services. This training was recorded and is now...
EVV Alternative Device Policy Changes Effective September 2, 2025
Community First Health Plans would like to inform Providers that the Texas Health and Human Services Commission (HHSC) posted new and revised policies for alternative device reduction reviews on HHSC's Electronic Visit Verification (EVV) webpage. The policies are...
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