Provider Information

Texas Medicaid and CHIP provider resources include information on provider enrollment and re-enrollment, rate analysis, the CHIP Perinatal program, physician-administered drugs and communications resources.

Contacts for Providers

Claims Administration and Provider Enrollment

Texas Medicaid & Healthcare Partnership (TMHP) is the claims administrator for Texas Medicaid.

Technical Support for Filing Claims: 888-863-3638

Filing Claims for Managed Care Services

Claims for services administered by a medical or dental plan must be submitted to the plan. Providers may submit managed care claims by the following:

  • Submit acute, long term services or dental claims directly to the appropriate medical or dental plan using the methods established by the plan.
  • Submit acute care or dental claims electronically to TMHP for routing to the appropriate medical or dental plan.

Provider Complaints and Appeals


Medicaid fee-for-service providers must exhaust the administrative and medical appeals provider resolution process with the HHS claims administrator contractor before filing an appeal or complaint with HHSC. Written appeals and complaints may be sent to HHSC at:

Texas Health and Human Services Commission
HHSC Claims Administrator Contract Management
P.O. Box 204077
Mail Code 91-X
Austin, TX 78720-4077

Medicaid Managed Care

Medicaid managed care providers should exhaust the complaints or grievance process with their managed care medical or dental plan before filing a complaint with HHSC. If after completing this process, the provider believes they did not receive full due process from the managed care medical or dental plan, they may file a STAR, STAR+PLUS, STAR Health, STAR Kids or managed care dental complaint or inquiry by using the Online Question or Complaint Form or by emailing

Learn how to submit a complaint for issues such as claims, what you will need and what you can expect (PDF)

You can see the complaint process by viewing the Health Plan Management Complaint Process flow chart (PDF). An accessible version of the steps in the complaint process (PDF) is also available.

Providers also may mail STAR, STAR+PLUS, STAR Health, STAR Kids or children's Medicaid dental services complaint or inquiry to:

Texas Health and Human Services Commission
Health Plan Management
Mail Code H-320
P.O. Box 85200
4900 N. Lamar
Austin, TX 78708-5200

Providers can submit appeals directly to the medical or dental plan that administers the clients' managed care benefits. Claims that originally were submitted to TMHP for routing to the appropriate medical or dental plan can be appealed to TMHP using TexMedConnect or EDI. The appeals will be routed to the appropriate entity for processing.

For additional information see Texas Administrative Code, 1 TAC 354


CHIP call center: 877-543-7669 or 800-647-6558

CHIP Processing Center:
Texas Health and Human Services Commission
P.O. Box 149024
Austin, TX 78714-9024

Provider Appeals of Medical Necessity and Utilization Review Decision (Fee-For Service)

Appeals of HHSC Office of the Inspector General (OIG) Utilization Review (UR) Decisions

Written appeals may be sent to HHSC Medical and UR Appeals at:

HHSC Medical and UR Appeals
Mail Code H-230
PO Box 85200
Austin, TX 78708


Physical address (if required for express delivery service):

HSC Medical and UR Appeals
Broadmoor Building 902
11501 Burnet Road
Austin, TX 78758

Questions may be e-mailed to Utilization Appeals.

For additional information on Medical and UR Appeals refer to the HHSC Medical and UR Appeals page.

Appeals of Recovery Audit Contractor (RAC) decisions

Written appeals are submitted through Health Management Systems, Inc. (HMS), not directly to HHSC Medical and UR Appeals.

For submissions by mail, please use the following address:

HHSC Medical and UR Appeals
5615 High Point Drive
Mail Stop #200-TX
Irving, TX 75038


Click here for submissions via HMS Provider Portal.

For further information, providers can contact HMS Provider Services at 877-401-3635 or click here.