Reminder: Removal of Texas Provider Identifiers (TPIs) Number from Prior Authorization Forms, Claims Forms and Instructions Effective Sept. 1, 2021

September 08, 2021

What’s new?
Effective Sept. 1, 2021, Texas Medicaid and Healthcare Partnership (TMHP) Learn more about third-party links providers will no longer be required to use their TPIs for submitting paper claims, paper prior authorization requests or for calling TMHP. The TPIs will be removed from prior authorization forms, claim forms and instructions.

What’s next?
Instead of the TPIs, providers must use their National Provider Identifiers (NPIs) on forms effective Sept. 1, 2021. Providers or individuals may be issued an Atypical Provider Identifiers (APIs) by Texas Health and Human Services (HHSC) if they do not provide health-care services or are not required to have NPIs. These providers should use their APIs instead of the TPIs.

Stop Using TPIs
By Dec. 9, 2021, providers should stop using TPIs. TMHP will continue to accept older forms that include TPIs from Sept. 1, 2021 until Dec. 8, 2021 to assist with the transition of the phase out of TPIs. After this transition period ends, only the revised NPI/API forms will be accepted.

Additional Information
For more information, call the TMHP Contact Center at 1-800-925-9126 or the TMHP-CSHCN Service Program Contact Center at 1-800-568-2413.

Have questions
Contact our BCBSTX Medicaid Provider Service Center at 1-877-560-8055 or contact your BCBSTX Medicaid Provider Network Representative at 1-855-212-1615.

The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.

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