Provider News
Provider Enrollment and Management System (PEMS) Frequently Asked Questions May 2025
Community First Health Plans is requiring Providers to ensure their information is aligned across the Provider Enrollment and Management System (PEMS) Master Provider File effective May 30, 2025. As a Managed Care Organization (MCO), Community First Health Plans will...
Sleep Studies Policy to be Updated Effective March 1, 2025
Updates made to the Sleep Studies Medicaid Policy will become effective for date of service on or after March 1, 2025. Benefit information will be updated in the Texas Medicaid Provider Procedures Manual (TMPPM), Medical and Nursing Specialists, Physicians, and...
Healthy Texas Women (HTW) Providers Must Recertify in PEMS and Update Demographic Information
Healthy Texas Women (HTW) providers who intend to begin or continue delivering HTW services must complete their annual recertification process. The deadline for 2025 program year recertification has been extended to April 30, 2025. As part of this process, Providers...
2024 Cost Report and 2024 / 2025 Accountability Report Training Information
HHSC published Information Letter No. 2024-15 regarding the 2024 Cost Report and 2024 and 2025 Accountability Report Training Information. Preparers must attend cost report training for every program for which a cost or accountability report is submitted. If...
Coming Soon: PEMS to Be Updated to Allow Provider Credentialing
Beginning May 30, 2025, the Provider Enrollment and Management System (PEMS) will be enhanced to streamline the process for Texas Medicaid enrollment and credentialing with Community First Health Plans, Inc. (Community First). This new feature will allow Providers to...
Payspan Portal Production Maintenance – Saturday, April 12, 5:00 P.M. (ET) through Sunday, April 13, 8:00 A.M. (ET)
Zelis® is utilizing a maintenance window for the Payspan Portal that starts at 5:00 P.M. (ET) on Saturday, April 12, 2025, and ends at 8:00 A.M. (ET) on Sunday, April 13, 2025. Note: We will end the maintenance early if the activities are completed...