MedicaidAdministrativeHigh impact
Reminder: CLIA Certification Required for Laboratory Service Claims
Texas Medicaid·TX·General
We identified it
Feb 19, 2026
Summary
Texas Medicaid now requires all laboratory service providers to have current CLIA certifications and submit claims only for services covered under their certification. Providers must update their CLIA information in PEMS and ensure compliance before billing any laboratory services.
Action Required
Immediately: Verify current CLIA certification status in PEMS system. Billing team must ensure all laboratory service claims match procedures covered under current CLIA certification. Update CLIA information through PEMS Maintenance, Existing Enrollment, or Revalidation transactions as appropriate. Stop billing for any laboratory procedures not covered under current CLIA certification as claims will be denied without proper certification.