Texas MedicaidHigh ImpactAdministrative

Issue Identified With Certain Newly-Issued Texas Medicaid PCNs

Published March 14, 2026

AI Summary

Texas Medicaid has identified a system issue where newly-issued patient control numbers (PCNs) beginning with '9' may incorrectly appear as ineligible in TMHP systems. Providers must manually verify eligibility through the Medicaid Client Portal before processing claims for these patients.

Action Required

Immediately: For all Texas Medicaid patients with PCNs beginning with '9', billing team must verify eligibility through the Medicaid Client Portal before submitting claims. Use the Medicaid Client Portal Job Aid for Providers for access instructions. Contact TMHP Contact Center at 800-925-9126 for assistance. Failure to verify eligibility may result in incorrect claim denials.

Plan Types

Medicaid

States

TX

Specialties

all-specialties