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. Pharmacies 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:
Enrollment Process
- Refer to the enrollment process and find this year's enrollment fee amount.
- Download enrollment forms.
- Download the pharmacy delivery sign.
- Enroll in the Medicaid Comprehensive Care Program (CCP)
- Enroll as a durable medical equipment (DME) provider
- Review resources for 340B providers
Operations
- Search enrolled pharmacies
- Refer to the Pharmacy Provider Procedure Manual
- Refer to the pharmacy payer sheets
- Review the instructions for maintaining your enrollment.
- Review continuing education modules and other training opportunities
- Review the weekly payment cycle
- Signup for direct deposit
- Access your weekly payment files
- Review the annual payment delays
- Learn about real-time client eligibility verification options