Community First Health Plans is sharing important updates regarding extensions to revalidation due dates and enrollment period gap closures. These changes, offered by the Texas Health and Human Services Commission (HHSC) and the Texas Medicaid & Healthcare Partnership (TMHP), provide additional time for Providers to complete their in-flight revalidation and reenrollment applications through the Provider Enrollment and Management System (PEMS).
Note: “In-flight” refers to an application that has been fully completed and submitted through PEMS but is not yet approved. Applications in “Draft” status are not considered in-flight.
Revalidation Due Date Extensions:
Providers scheduled for revalidation through May 31, 2026, will receive extensions if they have not completed revalidation by their due date:
- Providers that have not previously received an extension will receive an additional 180 calendar days.
- Providers that have already received one extension will receive another 180 calendar days.
PEMS checks daily for Providers due for revalidation the following day. If revalidation is incomplete, PEMS will automatically apply the appropriate extension to the current due date.
The updated due date will appear in the Revalidation Due Dates column on the Provider Information page in PEMS. Providers will also receive an email notification confirming the new due date.
Important: Revalidation is not complete until the request shows “Closed – Enrolled” status. Submitting the request is only the first step; it must go through review and be approved.
Enrollment Period Extension Requirements:
Providers disenrolled for not revalidating on time between November 1, 2023, and December 12, 2024, and who have an in-flight reenrollment application as of November 30, 2025, will be granted an extension through January 31, 2026, to complete reenrollment and qualify for retroactive enrollment.
If reenrollment is completed by January 31, 2026, the Provider’s National Provider Identifier (NPI) enrollment period begin date in PEMS will be backdated up to 365 calendar days to reduce or eliminate the enrollment gap. Providers who do not complete reenrollment by this date will not be eligible for a reduced gap.
Note: Providers submitting a reenrollment application after November 30, 2025, are not eligible for a reduced enrollment gap.
PEMS Revalidation and Reenrollment Resources:
Providers may refer to the PEMS educational videos on TMHP’s Provider Enrollment & Management System Playlist on YouTube, which includes the following:
- Revalidating an Individual
- Revalidating a Performing Provider
- Revalidating a Clinic/Group Practice or Facility
The following resources provide more information about Medicaid provider revalidation requirements and common deficiencies to avoid:
- Common Deficiencies Identified by the Office of Inspector General (OIG)
- Provider Enrollment Revalidation in PEMS
- ACA Screening Requirements
Providers may refer to the TMHP Notice, Provider Enrollment Help page, or the PEMS Instructional Site on TMHP.com for additional revalidation or reenrollment support.
Providers are encouraged to share this information with their staff. If you have any questions about this notice, please email Provider Relations at ProviderRelations@cfhp.com or call 210-358-6030. You can also contact your Provider Relations Representative directly.
To access all Provider alerts:
- Log into the Community First Provider Portal
- Go to CommunityFirstHealthPlans.com/Provider-News
- Sign up for the Community First Provider eNewsletter
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