MedicaidAdministrativeHigh impact
Texas Medicaid IDs and PCNs Starting With “9”
Texas Medicaid·TX·General
We identified it
Mar 24, 2026
Summary
Texas Medicaid has identified system issues with newly issued Medicaid IDs and patient control numbers (PCNs) that begin with '9'. These numbers may appear as ineligible in TMHP systems for prior authorization and acute care claims, affecting long-term care billing and general claim submissions.
Action Required
Immediately: For any Texas Medicaid patients with IDs or PCNs starting with '9', billing team must verify eligibility through the Medicaid Client Portal before submitting claims for prior authorization or acute care services. Check long-term care patient eligibility separately through LTC-specific verification. Claims may be incorrectly rejected without manual eligibility verification.