A pharmacy provider with a current license or registration with the Texas State Board of Pharmacy, or is licensed under the laws of another state and is free from any pharmacy board restriction, may apply to become a Texas Medicaid pharmacy provider.

Pharmacy providers must enroll with HHSC through the Provider Enrollment and Management System (PEMS) before providing outpatient prescription services and participating in any managed care network. MCOs must allow any pharmacy provider willing to accept the terms and conditions of their contract to enroll in their network. Pharmacy providers should contact the client's specific MCO to participate in Medicaid or CHIP managed care networks.

PEMS Information

• Enroll using the Provider Enrollment and Management System (PEMS).
• Refer to TMHP for instructions:
  • TMHP Provider Enrollment
  • Finding your Vendor ID in PEMS
  • Pharmacy Provider Enrollment Frequently Asked Questions (PDF).

Enrollment Process

• Refer to the Pharmacy Provider Procedure Manual to:
  • Refer to the enrollment process and find this year's enrollment fee amount
  • Enroll in the Medicaid Comprehensive Care Program (CCP)
  • Enroll as a durable medical equipment (DME) provider
• Download enrollment forms
• Download the pharmacy delivery sign
• Review resources for 340B providers

Operations

• Search enrolled pharmacies
• Search enrolled prescribing providers
• Refer to the Pharmacy Provider Procedure Manual to:
  • Review the instructions for maintaining your enrollment
  • Review the weekly payment cycle
  • Review the annual payment delays
  • Signup for direct deposit
  • Review continuing education modules and other training opportunities
    • Continuing education modules
    • Quick courses
    • Downloadable materials
    • TMHP Learning Management System
• Refer to the pharmacy payer sheets
• Refer to the VDP Provider Portal to:
  • Access your weekly payment files
  • Perform real-time client eligibility verification