Texas Incentives for Physicians and Professional Services (TIPPS) Program

The Texas Incentives for Physicians and Professional Services program is one of four directed payment programs (DPPs) HHSC submitted to the Centers for Medicare and Medicaid Services (CMS) for approval as part of the Delivery System Reform Incentive Payment Transition Plan. CMS approved TIPPS for state fiscal year (SFY) 2022 (Y1) on March 25, 2022. CMS approved TIPPS for SFY 2024 (Y3) on July 31, 2023.

Background

TIPPS is a DPP for certain physician groups providing health care services to children and adults enrolled in the STAR, STAR+PLUS and STAR Kids Medicaid managed care programs. Eligible physician groups include health-related institutions (HRIs), indirect medical education (IME) physician groups affiliated with hospitals and other physician groups.

The program includes three components:

• Component 1: Uniform dollar increase paid monthly. Physician groups affiliated with an HRI or a hospital receiving the IME add-on are eligible for Component 1.
• Component 2: Uniform rate enhancement paid semiannually. Physician groups affiliated with an HRI or a hospital receiving the IME add-on are eligible for Component 2.
• Component 3: Uniform rate enhancement for certain outpatient services. All physician groups are eligible for Component 3.

SFY 2024 (Y3) Measures and Requirements

• Y3 Requirements (PDF) (2/23/2023)
• Y3 Measure Specifications and FAQs (Excel) (9/8/2023)
• Stakeholder Feedback for Y3 (PDF) (2/23/2023)
• Getting Ready for Quality Reporting (PDF) (6/29/2023)
• Webinar recording: Getting Ready for Quality Reporting (6/29/2023)
• Webinar slide deck: Getting Ready for Quality Reporting (PDF) (6/29/2023)

SFY 2023 (Y2) Measures and Requirements

• Y2 Requirements (PDF) (8/9/2022)
• TIPPS Taxonomy Code Changes for Y2 (PDF) (1/10/2022)
• Y2 Measure Specifications (Excel) (3/23/2023)
• Y2 Measure Specifications FAQs (Excel) (3/23/2023)
• Stakeholder Feedback for Y2 (PDF) (3/1/2022)

SFY 2022 (Y1) Measures and Requirements

• Y1 Requirements (PDF) (4/8/2022)
• Y1 Measure Specifications (Excel) (8/9/2022)
• Y1 Measure Specifications FAQs (Excel) (8/9/2022)
• Stakeholder Feedback for Y1 (PDF) (3/8/2021)
• Y1 Provider-Reported Data (Excel) (10/27/2022)

Rules

• TIPPS rules §353.1309 and §353.1311

Contact Information

• Visit the HHSC Provider Finance Department website for more enrollment, eligibility and payment information for TIPPS.
• For program eligibility and financial questions, email HHSC PFD TIPPS.
• For questions on TIPPS quality requirements and reporting, email HHSC DPP Quality.

Reporting Portal Access

If you are participating in the CHIRP program, you will use the reporting portal to access templates, review technical guidance, and submit your quality reporting. If you need to add a user or change access, submit a contact change form.