Provider Network News

Stay informed with Provider Network News, our frequent publication for Parkland Community Health Plan providers. The News includes important updates, reminders, and guidance on topics such as claims processing, billing guidelines, policy changes, and more. Browse past issues below to stay current on information that supports your practice and helps ensure smooth coordination of care for our members.

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Results 1 - 20 of 171
  • Separate Password No Longer Needed for My Account

    08/11/2026

    This is an update to the article titled, “Inactive TMHP User Accounts Deactivated After 90 Days.” The Texas Medicaid & Healthcare Partnership (TMHP) has successfully transitioned My Account to IAMOnline, and providers will no longer need a separate password to access the application. Reminder: TMHP will deactivate provider accounts that have been inactive for 90 days or more. Providers must log in to their accounts or change their passwords every 90 days to avoid deactivation.

  • Medical Policy and Prior Authorization Notice: Biosimilar Utilization Management Strategy

    08/07/2026

    The purpose of this medical policy is to establish a biosimilar-first utilization management strategy for clinician-administered drugs (CADs) administered under the medical benefit and reimbursed via NDCHCPCS  crosswalk at Parkland Community Health Plan (PCHP). This policy requires preferential use of FDA approved biosimilar products over the reference product. It ensures consistent application of regulatory standards, promotes clinically appropriate utilization, and supports cost-eff...

  • Provider Survey: Annual Provider Network Verification

    08/03/2026

    PLEASE RESPOND BY AUGUST 31 Provider Survey: Annual Provider Network Verification Help Us Update Our Provider Records! Parkland Community Health Plan is asking providers to review and verify information included in our provider network records. Having accurate provider data helps us ensure that health plan members can access current and reliable information in our Provider Directory listings. This survey supports PCHP’s ongoing efforts to maintain accurate network data and meet regulatory requirements. Sc...

  • TMHP IAMOnline Activation Email Sent July 28, 2026

    07/28/2026

    Provider Network News August 4, 2026 TMHP IAMOnline Activation Email Sent July 28, 2026 Last updated on 7/28/2026 Parkland Community Health Plan (PCHP) would like to notify providers of an important update from the Texas Health and Human Services Commission (HHSC) and the Texas Medicaid & Healthcare Partnership (TMHP). Providers should check their email inbox for the Texas Medicaid & Healthcare Partnership (TMHP) IAMOnline activation email that was sent the evening of July 28, 2026, and follow th...

  • IAMOnline Educational Video Now Available

    07/24/2026

    Parkland Community Health Plan (PCHP) would like to notify providers of important updates from the Texas Medicaid & Healthcare Partnership (TMHP). The Texas Medicaid & Healthcare Partnership (TMHP) has added a new educational video titled “IAMOnline” to the TMHP YouTube channel and in the TMHP Learning Management System (LMS).

  • PCHP Prior Authorization Requirement Update

    07/23/2026

    Adhoc Review: 7/20/2026 Effective date of all prior authorization removals, addendums, and adds in this notice: 9/1/2026 PCHP has completed an ad hoc review of all services requiring prior authorization. This Provider Network News alert is notification only of updates and does not determine if the benefit is covered by PCHP. For specific CPT codes requiring prior authorization by PCHP, please review PCHP’s Prior Authorization List located at Providers. ParklandHealthPlan.com...

  • New Login Process for All Texas Medicaid Providers Through TMHP IAMOnline and Provider MFA Registration for Transition Release

    07/22/2026

    Effective August 24, the Texas Medicaid & Healthcare Partnership (TMHP) will add new applications to the TMHP IAMOnline platform. These changes will continue the transition to TMHP IAMOnline as the entry point for accessing applications on the TMHP webpage.

  • RSV Vaccine Services Procedure Code 90382 to Be Updated as Informational Effective July 1, 2025

    07/22/2026

    Last updated on July 10, 2026 Parkland Community Health Plan (PCHP) is sharing an important Texas Medicaid update regarding billing and reimbursement for respiratory syncytial virus (RSV) monoclonal antibody products. Effective for dates of service on or after July 1, 2025, procedure code 90382 (clesrovimab) will process as informational only. Reimbursement may be available for RSV monoclonal antibody administration services when billed with the appropriate administration procedure co...

  • Update to Cranial Remolding Orthosis (CRO) Benefit Criteria Effective September 1, 2026

    07/21/2026

    Parkland Community Health Plan (PCHP) is notifying providers of updated Texas Medicaid benefit criteria for Cranial Remolding Orthosis (CRO) (Procedure Code S1040). Effective for dates of service on or after September 1, 2026, benefit criteria will be updated in accordance with House Bill 426, 89th Legislature, Regular Session, 2025. These updates expand coverage criteria for members who require a cranial remolding orthosis as part of a treatment plan for qualifying cranial deformities.

  • Texas Health Steps (THSteps) EP1 Claim Processing Update

    07/13/2026

    Parkland Community Health Plan (PCHP) has identified a claims processing issue affecting certain THSteps EP1 claims with denial dates on or after May 8, 2026. Our review identified that certain THSteps EP1 claims were denied because the system evaluated the rendering provider for the required THSteps benefit code. The THSteps benefit code requirement applies to the billing provider, not the rendering provider. PCHP confirmed that some billing providers were appropriately enrolled with the required THStep...

  • TMHP IAMOnline Activation Email Sent July 7, 2026

    07/13/2026

    Parkland Community Health Plan (PCHP) would like to notify providers of an important update from the Texas Health and Human Services Commission (HHSC) and the Texas Medicaid & Healthcare Partnership (TMHP).

  • HHSC/TMHP Policy Update – Allergy Testing and E/M Services

    07/13/2026

    Parkland Community Health Plan (PCHP) would like to notify providers of an important update from the Texas Health and Human Services Commission (HHSC). HHSC has issued a policy language clarification regarding the proper use of Modifier 25 when billing for allergy testing and Evaluation and Management (E/M) services on the same date of service.

  • STELARA® Biosimilars: FDA-Approved Ustekinumab Biosimilars for Prescribing

    07/01/2026

    Preferred Biosimilar Options: PYZCHIVA™ (ustekinumab-ttwe). SELARSDI™ (ustekinumab-aekn). YESINTEK™ (ustekinumab-kfce). These products are FDA-approved biosimilars to STELARA® (ustekinumab) and may be prescribed for eligible patients requiring ustekinumab therapy.

  • STELARA® Biosimilars: Food and Drug Administration (FDA)- Approved Ustekinumab Biosimilars for Prescribin

    06/29/2026

    Preferred Biosimilar Options • PYZCHIVA™ (ustekinumab-ttwe) • SELARSDI™ (ustekinumab-aekn) • YESINTEK™ (ustekinumab-kfce) These products are FDA-approved biosimilars to STELARA® (ustekinumab) and may be prescribed for eligible patients requiring ustekinumab therapy

  • Reminder: Balance Billing Is Not Allowed

    06/22/2026

    PCHP is reminding Corrective Action Required providers of their obligations regarding balance billing If a provider has balance billed a Medicaid or CHIP for Medicaid and CHIP members. member, the provider must take prompt action to Members enrolled in STAR and CHIP have important remedy the situation and prevent future occurrences. rights and protections, including protection from This includes: balance billing. Members are not responsible for • Stopping the bill collection process immediately. payment ...

  • PCHP Prior Authorization Requirement Update

    06/16/2026

    PCHP has completed an annual review of all services requiring prior authorization. This provider network news alert is notification only of updates and does not determine if the benefit is covered by PCHP.

  • Home Use of Vestronidase Alfa-Vjbk (Mepsevii) is Covered by Texas Medicaid Effective July 1, 2026

    06/10/2026

    Last updated on 5/29/2026. Effective for dates of service on or after July 1, 2026, vestronidase alfa-vjbk (Mepsevii) (procedure code J3397) is a benefit of Texas Medicaid when provided in the home setting. Additionally, on July 1, 2026, the Texas Medicaid & Healthcare Partnership (TMHP) will move the benefit information about vestronidase alfa-vjbk (Mepsevii) in the Texas Medicaid Provider Procedures Manual (TMPPM), Outpatient Drug Services Handbook from subsection 6.83, “Mepsevii (Vestronidase alfa...

  • Procedure Code Q5135 Updated to Include Valid Diagnosis Code M0529

    06/09/2026

    Last updated on 5/29/2026 Effective May 14, 2026, for dates of service on or after October 1, 2024, the Texas Medicaid & Healthcare Partnership (TMHP) has deleted invalid diagnosis code M0259 and updated it to valid diagnosis code M0529 on injection tocilizumab-aazg (Tyenne) (procedure code Q5135). The diagnosis code M0259 was incorrectly listed. The correct diagnosis code is M0529.

  • Texas Medicaid now covers adult vaccines under pharmacy benefits, for eligible members 19 years and older

    06/03/2026

    Texas Medicaid now covers adult vaccines under pharmacy benefits, for eligible members 19 years and older

  • TMPPM Update for Telecommunications and Teledentistry

    05/21/2026

    Parkland Community Health Plan (PCHP) would like to notify providers of an important update from the Texas Health and Human Services Commission (HHSC). On July 1, 2026, the Texas Medicaid & Healthcare Partnership (TMHP) will update the Texas Medicaid Provider Procedures Manual (TMPPM) to revise language regarding record retention requirements for telemedicine medical services, teledentistry dental services, and telehealth services in accordance with House Bill 1700, 89th Legislature, Regular Session,...