State Taxonomy Requirement – Frequently Asked Questions

What provider types require a state registered taxonomy for claim payment?

Any provider who would like to receive Medicaid reimbursement for services rendered to Medicaid recipients. This includes rendering and billing providers, groups, and facilities.

What is required?

All claims submitted must include taxonomy that matches the state registration.

Providers must submit the Benefit Code Field (when applicable), Address field, and Taxonomy code field and all other required fields. These fields must be completed before submitting electronic claims.

Taxonomy codes do not affect pricing or the level of pricing, but rather are used to crosswalk the NPI to a TPI. It is critical that the taxonomy code selected as the primary or secondary taxonomy code during a providers enrollment with TMHP is included on al electronic transactions.

Billing providers that are not associated with a group are required to submit a taxonomy code on all electronic claims. Claims submitted without a taxonomy code may be rejected.

How do I enroll or update my taxonomy?

Via the online enrollment wizard at Texas Providers Medicaid Site   or call: 1-800-925-9126.

How long does it take to hear back from enrollment?

Please allow at least 15 business days for mailing and processing before checking the status of your submission.

Who should I contact with further questions?

You can visit the provider portal (https://www.tmhp.com/Pages/SupportServices/PSS_CC.aspx), or call 1- 800-925-9126. For questions concerning why Envolve has requested you take action, please contact Customer Service (866) 518-2602.