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.
- Enroll using the Provider Enrollment and Management System (PEMS).
- Refer to TMHP for instructions:
- 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
- Search enrolled pharmacies
- Search enrolled prescribing providers
- 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