-
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).
-
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...
-
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.
-
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...
-
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.
-
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...
-
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).
-
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.
-
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.
-
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
-
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 ...
-
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.
-
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...
-
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.
-
06/03/2026
Texas Medicaid now covers adult vaccines under pharmacy benefits, for eligible members 19 years and older
-
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,...
-
05/21/2026
On June 1, 2026, the Texas Medicaid & Healthcare Partnership (TMHP) will update section 9.2.47, “Newborn Services,” in the Texas Medicaid Provider Procedures Manual (TMPPM), Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook to remove the reference to procedure code 99360, which is not a benefit of Texas Medicaid. For more information, call the TMHP Contact Center at 800-925-9126.
-
05/21/2026
Parkland Community Health Plan (PCHP) would like to inform our network providers of an upcoming change to the Texas Medicaid & Healthcare Partnership (TMHP) login process. New Login Process Effective June 12, 2026 Beginning June 12, 2026, TMHP will transition to the TMHP IAMOnline platform as the new, secure entry point for accessing applications on tmhp.com. This platform provides a centralized, single sign-on experience for accessing TMHP systems. Important: This new login process applies only to T...
-
05/19/2026
Why Follow-Up Care Matters Timely follow-up after emergency department (ED) visits or hospitalization for mental health and substance use conditions is critical to improving patient outcomes, reducing readmissions and future hospitalization, and ensuring continuity of care. • Reduces repeat ED visits • Improves care engagement and recovery • Supports medication adherence and care coordination Measure Overview Two key HEDIS measures assess follow-up care after ED visits: • FUH: Follow-Up After Hospitaliz...
-
05/18/2026
Provider Network News May 14, 2026 Important Notice: CLIA Implementation Delayed Parkland Community Health Plan (PCHP) would like to notify providers of an important update from the Texas Health and Human Services Commission (HHSC) regarding Clinical Laboratory Improvement Amendments (CLIA) requirements. Key Details • The previously scheduled June 1, 2026 implementation of CLIA-related claim denials based on PEMS data has been delayed until further notice. • HHSC anticipates a delay of at least three mon...