Physicians with Medicaid revalidation due by or before May 31, 2026, will receive another 180-day extension to complete the process, and physicians who were disenrolled for not revalidating on time in 2023 and 2024, but now have an application in, have been granted additional time to complete the process, per a Dec. 12 announcement by the state’s Medicaid administrators.
The Texas Medicaid & Healthcare Partnership (TMHP) and Texas Health and Human Services Commission (HHSC) cautioned revalidation is not complete until a physician’s revalidation request is in “Closed – Enrolled” status, as indicated by the state’s Provider Enrollment and Management System (PEMS).
HHSC notes the 180-day extension applies to physicians who received one earlier extension to complete revalidation, as well as those who have not received any prior extensions.
Texas Medical Association staff advises physicians in this situation to confirm their revalidation due date and start the process at least 120 days prior.
In addition to the revalidation extension, the agencies announced a limited-time extension for physicians who were disenrolled for not revalidating on time between Nov. 1, 2023, and Dec. 12, 2024 – and who, as of Nov. 30, 2025, have submitted a completed application via PEMS that has not yet been approved by TMHP, which TMHP considers “in-flight.”
Those physicians will be granted an extension, through Jan. 31, 2026, to complete the reenrollment process and qualify for retroactive enrollment.
That also means those physicians can seek retroactive Medicaid payment for that disenrolled period, provided:
- The physician was disenrolled solely for failure to revalidate;
- The disenrollment happened between Nov. 1, 2023, and Dec. 12, 2024;
- An “in-flight” reenrollment application was submitted in PEMS by Nov. 30, 2025; and
- The reenrollment application is approved by Jan. 31, 2026.
Physicians who complete reenrollment by the Jan. 31 deadline will be able to have their enrollment date adjusted to reduce or eliminate the disenrolled period in which Medicaid payment may have been withheld.
Per the bulletin, a physician’s National Provider Identifier enrollment period beginning date will be backdated in PEMS by up to 365 calendar days. However, TMHP notes physicians who don’t complete reenrollment by Jan. 31, 2026, or who submitted reenrollment applications after Nov. 30, 2025, are ineligible for those adjustments.
According to an HHSC spokesperson, the extensions are being provided to allow physicians sufficient time to complete requirements. HHSC also says it is implementing enhancements to PEMS to better the enrollment and revalidation processes.
HHSC will make details regarding these initiatives, including projected timelines, available in the coming months.
For more information, TMHP offers these videos via YouTube:
The bulletin follows from prior notification in June, which extended revalidation to Nov. 30 following TMA advocacy.
Check out TMA’s latest updates on Medicaid changes, and reach out to TMA’s Physician Payment Resource Center for Medicaid, Medicare, or commercial insurance payment issues.
Phil West
Associate Editor
(512) 370-1394
phil.west[at]texmed[dot]org
Phil West is a writer and editor whose publications include the Los Angeles Times, Seattle Times, Austin American-Statesman, and San Antonio Express-News. He earned a BA in journalism from the University of Washington and an MFA from the University of Texas at Austin’s James A. Michener Center for Writers. He lives in Austin with his wife, children, and a trio of free-spirited dogs.