Provider Enrollment and Covered Services
How do I enroll as an HTW provider?
Providers who meet certain criteria might qualify to provide HTW services. These criteria include:
- Must deliver services available through the HTW program.
- Have completed the Medicaid enrollment process through the Texas Medicaid & Healthcare Partnership (TMHP).
- Certify that they do not perform or promote elective abortions or affiliate with an entity that performs or promotes elective abortions in accordance with the Healthy Texas Women program rules located in the Texas Administrative Code (TAC) Title 1, Part 15, Chapter 382, Subchapter A, §382.1 – 382.29. Teaching hospitals, independent laboratories, and radiology facilities providers are not required to certify.
Visit the Healthy Texas Women page on the TMHP website to learn more about provider requirements and find links to the enrollment and certification instructions. There is not a separate provider enrollment process for HTW Plus.
What is HTW Plus?
HTW Plus is an enhanced, cost-effective, limited postpartum care services package available to women enrolled in HTW who have been pregnant in the last 12 months.
What services do HTW and HTW Plus cover?
HTW provides a variety of women's health, preventive, and family planning services. Please visit the HealthyTexasWomen.org page for more information on HTW and HTW Plus.
You can visit the Healthy Texas Women page on the TMHP website to view the HTW Texas Medicaid Provider Procedures Manual for a list of covered procedure codes or the Drug Formulary for covered medications for HTW and HTW Plus.
Billing and Claims
How do I bill for HTW services?
Please visit the Healthy Texas Women page on the TMHP website to view the HTW Texas Medicaid Provider Procedures Manual for instructions on how to bill for HTW services.
How do I know if an applicant I have treated is enrolled in HTW and her claim will be paid?
To see if a woman is enrolled in the program call the TMHP Contact Center at 800-925-9126 (Option 5) or check in the Texas Medicaid Provider section of the TMHP website. (Look for the "Go to TexMedConnect" button).
Providers should make sure that a woman is enrolled in the program before billing. Claims received before enrollment will be denied, but providers can resubmit claims once a woman is enrolled.
Do clients have cost-sharing responsibility in HTW?
No. HTW Benefits are available for free to the woman, though clients may be asked to pay for services or treatment HTW does not cover.
Who can I contact for assistance?
Where can I find additional information on HTW?
Where should I direct clients who want to learn more about HTW?
Please direct clients to HealthyTexasWomen.org. The site has information on client eligibility, how to apply, benefits, and an online provider look-up.
If they need information not found on the website, they can call 2-1-1 or email HealthyTexasWomen@hhsc.state.tx.us.