Skip to Main Content

POSTPONED: Update to Allow Submission of Provider Credentialing Applications through HHSC’s PEMS for Medicaid and CHIP

Date: 05/15/25

Please Note: This is an update to a notice previously posted. Please reference the latest article, Coming Soon: PEMS Update to Allow Provider Credentialing.

The Texas Health and Human Service Commission (HHSC), the Texas Medicaid & Healthcare Partnership (TMHP), Managed Care Organizations (MCOs), Dental Maintenance Organization (DMOs), the Texas Association of Health Plans (TAHP) and the Texas Association of Community Health Plans (TACHP), the credentialing verification organization (Verisys), HHSC’s Enrollment Broker (Maximus), and other stakeholders have worked collaboratively on the Provider Enrollment and Management System (PEMS)+ project.

The primary scope of PEMS implementation includes both transition to  the PEMS-based Master Provider File (MPF) and the capability for providers to apply for managed care credentialing in PEMS. HHSC and the project stakeholders had been tracking toward a May 30, 2025, deployment date.

Due to concerns about the impact of these two major changes deploying at the same time and concerns about data discrepancies that must be addressed by TMHP and providers, HHSC is proceeding with the revised go-live plan as follows:

Phase I: Deploy the PEMS implementation as the source of validation of Medicaid and CHIP provider enrollment on May 30, 2025:

  • Implement loading and processing of the PEMS-based MPF.
  • Implement requirements for the MCOs to operationalize new file layouts, validations, and response files related to Medicaid and CHIP provider enrollment for the Provider Network Files (P-Files) that MCOs submit to TMHP.

Phase II: Deploy the submission of credentialing applications in PEMS on August 31, 2025.

If you have questions about PEMS or the upcoming credentialing option, please contact the Texas Medicaid & Healthcare Partnership (TMHP) Contact Center at 1-800-925-9126 or by completing a TMHP Contact Us form.

For questions related to Superior, please contact your local Provider Representative. To access their information, visit the Find My Provider Representative webpage.