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 (Year [Y] 1) on March 25, 2022. CMS approved TIPPS for SFY 2023 (Y2) on August 1, 2022.

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.

Proposed SFY 2024 (Y3) Measures and Requirements

The proposed quality requirements and measures are submitted to CMS for annual program review and approval. The final quality measures and reporting requirements will be posted following CMS' approval.

SFY 2023 (Y2) Measures, Requirements, and Evaluation

SFY 2022 (Y1) Measures, Requirements, and Evaluation

Rules

Contact Information

Forms

DPP Contact Change Form (PDF)