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10/31: Enrollment and Credentialing Deadline for Non-LMHA Providers of Mental Health Targeted Case Management and Rehabilitative Services

Date: 10/22/21

Effective October 31, 2021, Texas Medicaid & Healthcare Partnership (TMHP) is requiring non-Local Mental Health Authority (non-LMHA) providers of Mental Health Targeted Case Management and Mental Health Rehabilitative (MH TCM/MH Rehab) services to enroll and bill exclusively under the “MH Case Management/MH Rehabilitative Services—Non-LMHA” provider type. This new requirement is applicable to Superior HealthPlan Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS) and STAR+PLUS Medicare-Medicaid Plan (MMP) providers.

MH TCM/MH Rehab claims with dates of service on or before October 31, 2021, may be billed under existing provider types in managed care. MH TCM/MH Rehab claims with dates of service on or after November 1, 2021, may be denied if they are submitted under a provider type other than MH Case Management/MH Rehabilitative Services—Non-LMHA.

The following enrollment and credentialing steps must be completed no later than October 31, 2021:

  • Non-LMHA providers of MH TCM/MH Rehab services who are currently enrolled in a provider type other than MH Case Management/MH Rehabilitative Services-Non-LMHA should begin the TMHP enrollment process. To enroll, please visit THMP’s Provider Enrollment webpage.
    • Non-LMHA providers seeking to enroll in Medicaid to provide MH TCM/MH Rehab services for the first time must use the same process. 
  • After receiving approval for enrollment in Texas Medicaid, Non-LMHA providers must be contracted and credentialed by a Texas Medicaid MCO to provide services to Texas Medicaid eligible persons enrolled in Medicaid managed care. To be credentialed, please visit: Superior’s Network Request or Update webpage.
  • Non-LMHA providers also must register online to use the Texas Department of State Health Services (DSHS) Clinical Management for Behavioral Health Services (CMBHS) clinical record-keeping system before providing services to Texas Medicaid eligible persons. To register, please visit: HHSC’s Clinical Management for Behavioral Health Services webpage. 
    • Providers that have already applied for and received access to the CMBHS system with their current National Provider Identifier (NPI), do not need to apply again under their new provider type.

Please note: Non-LMHA providers who are contracted for services outside of the array of MH TCM/MH Rehab services are not required to complete the enrollment and credentialing process above for services other than MH TCM/MH Rehab.

To see full enrollment steps and details, and to access resources, please review: TMHP’s Notice - October 31, 2021 Enrollment and Credentialing Deadline for Non-LMHA Providers of Mental Health Targeted Case Management and Rehabilitative Services.

For questions, please contact your designated Account Manager.