# Texas NEMT Provider Enrollment in 2027: The TMHP Application, Step by Step Canonical URL: https://nemtguide.com/guides/texas-nemt-provider-enrollment/ ยท Updated 2026-10-02 The Texas NEMT provider enrollment application is the Texas Medicaid application you file with TMHP in PEMS, its online system. You must be enrolled before SafeRide Health or MTM Health can contract with you. You need an NPI, company papers, and full disclosures for every owner and manager. TMHP quotes up to 60 days for a complete file, and as of October 2026 a screening backlog can add weeks. - Enroll in Texas Medicaid through TMHP before a health plan's ride vendor can sign you. PEMS is the only way to apply. - TMHP lists demand response companies as limited risk: license and database checks, with no site visit or fingerprints. - Missing owner or manager disclosures are the most common reason the state sends an application back, which can add 25 business days. - Expect the federal application fee, $750 for applications filed in 2026, unless you already paid it to Medicare or another state. - Fee-for-service Medical Transportation Program trips also need an HHSC contract, open to applicants until September 15, 2027. ## What TMHP enrollment does, and what it does not TMHP, the Texas Medicaid & Healthcare Partnership, is the state's claims administrator. Under its contract with HHSC, it enrolls demand response transportation companies, including rideshare companies, for the Medical Transportation Program (MTP Handbook, October 2026). Family and friends who drive riders register with TMHP instead and get an Atypical Provider Identifier. Enrollment is the gate, not the work. The state's NEMT Services Handbook (section 2200) says a health plan or its ride vendor must confirm you are enrolled through TMHP before it signs an agreement with you. The [Texas state guide](https://nemtguide.com/states/texas/) explains which vendor serves which plans. This page walks through the application itself. ### Where trips come from after you enroll - **Health plan trips.** From October 1, 2026, each Texas Medicaid health plan's rides go through [SafeRide Health](https://nemtguide.com/brokers/saferide-health/) or [MTM Health](https://nemtguide.com/brokers/mtm-health/). You apply to each vendor after TMHP approves you. - **Fee-for-service MTP trips.** For members without a plan, HHSC contracts with demand response companies through open enrollment HHS0016482. It takes applications until 5 p.m. Central on September 15, 2027 (addendum 6, September 14, 2026). HHSC also adds an Economic Impact Payment of $36.28 per paid one-way trip from October 1, 2026, billed to HHSC on its own invoice within 95 days of the ride (addendum 8, September 24, 2026). HHSC must give 90 days' notice before it changes or ends that payment. The HHSC contract has its own bar. Applicants need at least one year of directly overseeing and managing NEMT, or engagements of similar scope that are current or were completed in the past two years. They must also show leadership, project management, and knowledge of Medicaid NEMT or comparable transportation, and give three references from customers served in the two years before they apply (addendum 3, December 29, 2025). Addendum 4 (April 9, 2026) defines comparable transportation as organized for-hire or volunteer rides with dispatched vehicles and drivers. Contractors must be registered with the Texas Secretary of State, enrolled with TMHP, pass a readiness review, and carry $1 million per accident in auto liability. A contractor may subcontract only with a company that is itself enrolled in Texas Medicaid. ## What to have ready before you open PEMS PEMS, the Provider Enrollment and Management System, is the only way to apply. Gather these first, because a request left in draft for 180 calendar days expires and cannot be submitted. TMHP emails a warning 30 days before (PEMS step-by-step guide, March 10, 2026). ### An NPI with the right taxonomy code You must have an NPI before you enroll. A company enrolls with an Organization NPI, and a sole proprietor enrolls with an Individual NPI (TMPPM section 1.1.4). PEMS gives an Atypical Provider Identifier only to individual transportation participants and a few other provider types, so a van or sedan company cannot skip this step. See [how to get an NPI](https://nemtguide.com/guides/how-to-get-an-npi-number-for-nemt/). PEMS fills your taxonomy choices from your NPPES record, so set the code in NPPES first. The MTP Handbook's code table recommends 343800000X for demand response providers and 347C00000X for rideshare companies, but its general code list shows 347C00000X for all MTP claims. Call the TMHP Contact Center at 800-925-9126 to confirm the code for your provider type before you attest, because the code on each electronic claim must match one on your enrollment (TMPPM section 1.7.3.4). The [taxonomy code page](https://nemtguide.com/glossary/taxonomy-code/) explains the codes. ### Your company papers The PEMS checklist for demand response companies (updated July 2026) asks for: - **Your EIN and tax classification.** The legal name on your formation papers must exactly match the one on your W-9. - **Formation papers,** if your company is incorporated in Texas: the Certificate of Formation and Certificate of Filing, or a Certificate of Authority, plus the Comptroller's Franchise Tax Account Status Page. A company formed in another state submits its Texas registration or Certificate of Authority and the same franchise tax page. - **An Assumed Name Certificate,** if the business name you use differs from the legal name on your W-9. - **A voided check or a signed bank letter,** if you want payments by electronic funds transfer. The same checklist lists no state license or certification for a demand response company. Local permits still apply where your city requires them. ### Details for every principal Each principal, and each subcontractor that takes on part of your management, completes an Owner/Creditor/Principal entry. TMHP counts as principals anyone with a 5% or larger ownership or control interest, every officer and director, every member or shareholder of an LLC or professional corporation, managing employees who run day-to-day operations, partners, and anyone authorized to act for the company (TMPPM section 1.1.9.3). A lender whose security interest covers at least 5% of your listed property counts too. For each one, PEMS asks for a Social Security number or ITIN, driver's license details, any professional health care license, proof of compliance with any court-ordered child support, and proof of the right to work for anyone who is not a U.S. citizen. ## Filling out the application, step by step 1. **Open PEMS and start a new enrollment.** Sign in through your TMHP account, choose Start New Enrollment, and confirm the NPPES details PEMS shows for your NPI. Answer no to the change of ownership question unless you are buying an enrolled company. 2. **Pick the program and provider type.** Choose the MTP program. TMHP's PEMS provider type list names the demand response type Demand Response Subcontractor. 3. **Complete every page.** The checklist names provider information, NPI and taxonomy, services provided, practice location, licenses, ownership and controlling interest, disclosures, accounting and billing, programs, agreements, application fee, and attachments. 4. **Enter every principal.** The person who signs the provider agreement certifies that every required principal has an entry and that each entry is complete (TMPPM section 1.1.9.2). 5. **Answer the disclosure questions in full.** The Texas HHS Office of Inspector General says to disclose every conviction except traffic violations, however old, including deferred adjudication, first offender programs, and expunged records. A conviction does not automatically bar you. Hiding one can get the application denied, or the enrollment terminated later. 6. **Pay the fee if PEMS asks.** The federal application fee is $750 for applications filed in 2026 (CMS notice of December 3, 2025), and TMHP cannot process an application that owes it. You skip it only if you already paid it to Medicare or another state's Medicaid or CHIP program and upload proof. The [2026 fee report](https://nemtguide.com/news/medicaid-enrollment-fee-750/) covers who pays. 7. **E-sign the HHSC Medicaid Provider Agreement.** For a company, a principal with authority to bind it signs. Signing certifies the whole application is true, and false or incomplete answers can bring administrative, civil, or criminal liability. 8. **Upload your attachments and submit.** Then watch your email and your PEMS dashboard, because deficiency notices arrive there and you have 30 business days to answer one. ## How long it takes and what slows it down TMHP says the process typically takes up to 60 days once it has everything it needs. If it finds the application incomplete, you get 30 business days to send what is missing, or TMHP ends the process and you start over (TMPPM section 1.1.9). Across the whole application, PEMS allows 165 cumulative business days to fix every deficiency (section 1.1.3). Screening adds time. After TMHP finds the application complete, it goes to the Office of Inspector General, which has 10 business days by statute. As of October 2026, the OIG's provider enrollment page says a high volume of applications has most taking 90 to 120 days from the time it receives them. It names missing or incomplete disclosures as the most common deficiency, adding up to 25 business days plus your time to respond. The OIG reminds providers that managing employees, such as an administrator, must be disclosed along with the owners. The screening itself is light for this provider type. As of July 2026, the PEMS checklist puts demand response companies in the limited risk category for new enrollment, revalidation, and reenrollment. Under 42 CFR 455.450, limited risk means license verification and database checks, without the site visit that moderate risk brings or the fingerprints that high risk brings. The state must raise a provider to high risk after a payment suspension for a credible allegation of fraud, waste, or abuse, an outstanding Medicaid overpayment, or an exclusion in the past 10 years. The [Medicaid site visit guide](https://nemtguide.com/guides/medicaid-site-visit/) covers what happens when one is required. If TMHP denies the application, ask for an informal desk review in writing through PEMS: within 20 business days of the letter when the denial follows an OIG recommendation, or 30 calendar days otherwise (TMPPM section 1.1.7). See [what to do when a Medicaid application is denied](https://nemtguide.com/guides/medicaid-application-denied/). ## After approval: first claims and vendor contracts TMHP emails you when the application is approved, and your Welcome Letter in PEMS shows your enrollment effective date. You can bill only for rides on or after that date. A newly enrolled provider's claims must reach TMHP within 95 days of the date enrollment is complete and within 365 days of the ride (TMPPM section 1.6). Three tasks come next: 1. **Set up payment.** Submit an electronic funds transfer request in PEMS with a voided check or bank letter. TMHP pays weekly with a Remittance and Status report. 2. **Set up billing.** TexMedConnect is TMHP's free claims tool for fee-for-service claims. Fee-for-service rides bill under [T2003](https://nemtguide.com/glossary/t2003/), paid per one-way leg at the metro, micro, or rural rate for the county where the trip starts (HHS0016482 section 8.25.2 and addendum 6). 3. **Apply to the vendors.** Send SafeRide Health and MTM Health your NPI and enrollment details, then finish their credentialing. The [SafeRide Health in Texas](https://nemtguide.com/brokers/saferide-health/texas/) and [MTM Health in Texas](https://nemtguide.com/brokers/mtm-health/texas/) pages list their plans and steps, and [NEMT broker credentialing](https://nemtguide.com/guides/nemt-broker-credentialing/) lists what vendors usually collect. ## Keeping your enrollment active Enrollment needs upkeep, and a lapse cuts off plan trips as well as fee-for-service claims. - **Changes in people.** Report a change in owners, officers, directors, or managing employees within 30 calendar days (TMPPM sections 1.1.9.4 and 1.4.4). A buyer files a new enrollment within 30 calendar days of a change of ownership (section 1.5). - **Changes in details.** Report a new address, phone number, legal name, or tax ID within 90 calendar days, through a PEMS maintenance request (TMPPM section 1.7.3). - **Monthly exclusion checks.** Screen every employee and contractor each month against the federal exclusions list and the HHSC OIG list (section 1.3.1). Civil money penalties can follow if you employ or contract with an excluded person. - **Revalidation, usually every five years.** Your Welcome Letter and PEMS show your enrollment period, and PEMS opens your revalidation up to 180 days before the due date. A request submitted before the due date that closes within a 45-day grace period leaves no gap. For due dates on or after June 16, 2026, PEMS adds 60 days on the due date when your revalidation is already submitted and still in review. TMHP says revalidations with deficiencies take 100 days longer on average. - **Claim activity.** TMHP disenrolls a billing location with no claim activity for 24 months, after a warning letter at 18 months (TMPPM section 1.3). If all your rides are plan trips billed to the vendors, ask TMHP whether the rule reaches your location. Missing a revalidation date disenrolls you from every Texas health care program, health plans included, and reenrollment means a new application and new screening. Put the date on your calendar now, and see the [Medicaid revalidation guide](https://nemtguide.com/guides/medicaid-revalidation/) and [how to report changes to Medicaid](https://nemtguide.com/guides/report-changes-to-medicaid/). ## Frequently asked questions ### Do I have to enroll with TMHP to drive for SafeRide Health or MTM Health? Yes. Section 2200 of the state's NEMT Services Handbook, chapter 16.4 of the Uniform Managed Care Manual, says a health plan or its ride vendor must make sure a demand response provider is enrolled in Texas Medicaid through TMHP before signing an agreement with it. Enroll first, then apply to the vendors for the plans in your counties. ### Can a NEMT company enroll in Texas Medicaid without an NPI? No. The Texas Medicaid Provider Procedures Manual (October 2026) says you must get an NPI before you enroll. PEMS gives an Atypical Provider Identifier only to individual transportation participants, the family and friends who drive riders, and a few other provider types, so a van or sedan company needs its own NPI from NPPES. ### Will TMHP inspect my office or fingerprint me? Not as a rule. As of July 2026, the PEMS checklist puts demand response companies in the limited risk category for new enrollment, revalidation, and reenrollment. Under 42 CFR 455.450, limited risk means license and database checks without a site visit or fingerprints. The state must move a provider to high risk after a payment suspension for suspected fraud, an outstanding Medicaid overpayment, or an exclusion in the last 10 years. ### How much does Texas Medicaid enrollment cost? The federal application fee is $750 for applications filed from January 1 to December 31, 2026, and CMS sets a new amount each year. PEMS tells you at the end of the application whether you owe it. You do not pay it again if you already paid it to Medicare or another state's Medicaid or CHIP program and upload proof. ### How long does TMHP enrollment take? TMHP says up to 60 days once it has everything it needs. As of October 2026, the Texas HHS Office of Inspector General says a backlog has most applications taking 90 to 120 days from the time it receives them, and a missing disclosure can add about 25 business days. File early and complete. ### Does TMHP enrollment get me fee-for-service Medical Transportation Program trips? Not by itself. HHSC buys demand response rides for fee-for-service members through contracts awarded under open enrollment HHS0016482, which takes applications until 5 p.m. Central on September 15, 2027. Applicants need TMHP enrollment, at least a year of directly managing NEMT or similar work current or completed in the past two years, and three references from customers served in those two years. ### What can I do if TMHP denies my application? Ask HHSC for an informal desk review in writing through PEMS. The deadline is 20 business days from the date on the letter when the denial follows an Inspector General recommendation, and 30 calendar days for any other reason. HHSC's decision after that review is final. ## Official resources - [TMHP: Provider Enrollment and Management System (PEMS) login](https://secure.tmhp.com/pems/) - [TMHP: PEMS step-by-step guide](https://www.tmhp.com/topics/provider-enrollment/pems/start-application) - [TMHP: Provider Enrollment Help, videos and training](https://www.tmhp.com/topics/provider-enrollment/provider-enrollment-help) - [Texas HHS OIG: Provider enrollment and common deficiencies](https://oig.hhs.texas.gov/resources/providers/provider-enrollment) - [Texas HHSC: Open Enrollment HHS0016482 for demand response transportation](https://resources.hhs.texas.gov/open-enrollment/hhs0016482) - [Texas HHS OIG: Exclusions search](https://oig.hhs.texas.gov/exclusions)