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New TMHP CLIA Laboratory Certification Web Page Now Available
Effective date
Not stated in the notice
Identified
Aug 18, 2026
Summary
TMHP has launched a new CLIA Laboratory Certification web page with an updated HCPCS Certification Data spreadsheet that maps procedure codes to required CLIA laboratory certifications. Providers performing laboratory services must ensure their CLIA certification information is current in PEMS to receive Medicaid reimbursement, and must verify that codes are Texas Medicaid benefits before billing.
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What to do
Action · 11 steps
01IMMEDIATE: Billing team must.
02Access the new TMHP CLIA Laboratory Certification web page at tmhp.com and download the HCPCS Certification Data spreadsheet.
03Cross-reference all laboratory procedure codes currently billed by the practice against the required CLIA certifications listed in the spreadsheet.
04Verify each code is a Texas Medicaid benefit using the Online Fee Lookup tool.
05Review current CLIA certification status in PEMS immediately.
06Determine enrollment status (disenrolled, enrolled outside revalidation window, enrolled within revalidation window, or revalidation already submitted).
07Submit appropriate PEMS transaction (Reenrollment, Maintenance, Existing Enrollment, or Revalidation) with updated CLIA information on the License/Certification/Accreditation tab based on enrollment status.
08Ensure CLIA certifications match those required for all laboratory codes being billed.
09DEADLINE: Complete PEMS CLIA updates before the next revalidation cycle to avoid claim denials.
10CONSEQUENCE: Claims for laboratory services will be denied if provider's CLIA certification does not match CMS/TMHP requirements for the billed procedure code, or if CLIA information in PEMS is outdated.
11Contact TMHP at 800-925-9126 or TMHP-CSHCN at 800-568-2413 for assistance.
Original notice
New TMHP CLIA Laboratory Certification Web Page Now Available
tmhp.com · Always check the source before changing claims.