Update Healthy Texas Women (HTW) New Requirements for Provider Certification – Texas Medicaid

Updated July 22, 2021

What’s new
Effective for dates of service on or after August 1, 2021, in addition to the providers who are required to complete a HTW, the Texas Health and Human Service Commission (HHSC) Learn more about third-party links will require most provider types and provider specialties to complete a HTW certification to be reimbursed for HTW services. No action is needed if the provider has a current HTW certification.

Why it matters
You will not be reimbursed for HTW services if you don't complete the HTW certification on or after August 1, 2021. Providers who complete the certification after August 1, 2021, will be reimbursed for HTW services provided on or after their certification date.

How to complete HTW certification
Use the Provider Information Management System (PIMS) Learn more about third-party links PDF Document and follow the instructions on how to complete the HTW certification and attestation.

Exempt HTW providers
The following HTW providers are exempt from the HTW certification requirements, but must still comply with HTW program policy for reimbursement:

  • Independent laboratories
  • Radiology providers
  • Teaching hospitals

Denied Claims
Some HTW claims submitted with dates of service from June 1, 2021 through June 11, 2021, may have been denied because an HTW certification was not on file for the provider. Affected claims will be reprocessed and providers might see an additional payment on their remittance and status (R&S) report.

Additional information
Please reference the Texas Medicaid Provider Procedure Manual Learn more about third-party links for additional information regarding HTW policies, including provider enrollment and the HTW certification. You can also reference the Healthy Texas Women Program Handbook.Learn more about third-party links PDF Document

You can 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.

Learn more about third-party links By clicking this link, you will go to a new website/app (“site”). This new site may be offered by a vendor or an independent third party. The site may also contain non-Medicare related information. In addition, some sites may require you to agree to their terms of use and privacy policy.

Revised: 07162021