Outreach and Education

Pharmacy providers enrolled in Medicaid are uniquely positioned to help clients with their pharmacy benefits. Pharmacy providers need to know what pharmacy items Medicaid pays for, which products require prior authorization, and who to contact with questions about claim processing. HHSC provides the resources in this section to assist pharmacy providers in accomplishing this.

Continuing Education Modules

Texas Health Steps offers more than 40 continuing education courses accredited by the Accreditation Council of Pharmacy Education (ACPE). Pharmacy-related continuing education modules include the following:

  • Pharmacy (txhealthsteps.com/653-pharmacy)
    • This module equips pharmacists and pharmacy providers in delivering outpatient pharmacy services to people enrolled in Texas Medicaid, Children’s Health Insurance Program, Children with Special Health Care Needs Services Program, Healthy Texas Women Program, and Kidney Health Care Program.

Downloadable Materials

HHSC encourages pharmacy providers to download the following materials, display them within the pharmacy, and reproduce them for internal education.

Document Name Revision Date
Dispensing 72-hour Emergency Prescriptions Instructions July 2019
Find the Formulary on Epocrates July 2022
Managed Care Complaint Process May 2023
Medicaid Formulary Information July 2022
Mosquito Repellent Benefit Information (for pharmacies) May 2022
Mosquito Repellent Benefit Information (for clients) (English) June 2022
Mosquito Repellent Benefit Information (for clients) (Spanish) June 2022
Provider Enrollment and Management System May 2022
Pharmacy Resources for Managed Care Information May 2022
Real-time Eligibility Verification Information July 2019

Refer to the Education Documents to download these materials.

Quick Courses

Texas Health Steps quick courses are short, targeted training modules. Most take 15 minutes or less to complete and do not offer continuing education credit. Pharmacy-related quick courses include the following:

TMHP Learning Management System

The TMHP Learning Management System is an education portal where all provider types can learn about Texas Medicaid. To access the LMS, providers must register and obtain a username. Refer to the LMS Registration and Navigation Job Aid to learn more about creating an account and navigating the LMS.

Pharmacy-related computer-based training (CBT) modules include the following:

  • Durable Medical Equipment
    • The Pharmacy DME CBT provides DME and pharmacy DME providers information and resources necessary to enroll in Medicaid as a DME provider and provide DME and supplies to Medicaid clients.
  • NDC Requirements for the Submission of Clinician-Administered Drug Claims
    • Provides information about national drug code (NDC) and healthcare common procedure coding system (HCPCS) requirements on clinician-administered drug claims.
  • Provider Enrollment and Management System (PEMS)
    • The PEMS CBT modules present information about PEMS and the different types of provider enrollment applications.