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Reminder: CLIA Certification Required for Laboratory Service Claims
Act
immediately
Effective date
Not stated in the notice
Identified
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.
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What to do
immediately · 4 steps
01Verify current CLIA certification status in PEMS system.
02Billing team must ensure all laboratory service claims match procedures covered under current CLIA certification.
03Update CLIA information through PEMS Maintenance, Existing Enrollment, or Revalidation transactions as appropriate.
04Stop billing for any laboratory procedures not covered under current CLIA certification as claims will be denied without proper certification.
Original notice
Reminder: CLIA Certification Required for Laboratory Service Claims
tmhp.com · Always check the source before changing claims.