Provider News Feed

The Texas Health and Human Services Commission (HHSC) has postponed the planned update to the Provider Enrollment and Management System (PEMS) that would enable provider credentialing. This functionality will be added later in 2025.

MCNA has added the American Dental Association (ADA) Guide to Extractions – Tooth and Remnants to our provider resources. This ADA resource is a helpful tool to provide guidance to your team when submitting claims for services to MCNA. The guide can be found in the News and Resources section of our website. Please read our provider bulletin for more information.

Version 1.28 of the Texas Medicaid and CHIP Provider Manual is now available with an effective date of March 1, 2025. You will find a summary of the changes in the Revision History located at the back of the manual. We encourage you to download a copy of the new Texas Provider Manual today at https://manuals.mcna.net/texas.

MCNA is hosting the following online webinar training sessions:

April 29, 2025

• 11:00am or 1:30pm: CHIP Presentation

May 27, 2025

• 11:00am or 1:30pm: Submission of X-rays, Narratives, and Photos

June 24, 2025

• 11:00am or 1:30pm: General Anesthesia Cases for Members Aged 6 and Under

Please visit our Provider Training Webinars page to RSVP at least 24 hours before the scheduled webinar to ensure that you receive an invite. For questions, please contact the MCNA Provider Hotline at 1-855-776-6262.

The U.S. Department of Health and Human Services Office of Inspector General (OIG) has released an important notice about a fraud scheme with the potential for large losses. In the scheme identified by OIG, fraudsters diverted Federal and State payments intended for providers participating in the Medicare and Medicaid programs. Please access the full Fraud Survey Report on OIG's website to learn more.

The next issue of MCNA’s provider newsletter, Dental Details, is now available! Check your email or download the latest issue.

In this issue:

• Celebrating National Dentist’s Day and Dental Hygienists’ Week

• Emerging Technologies in Dental Care

• Preparing for Tax Season

• How to Build a Strong Dental Team

• Question of the Quarter

If you are not subscribed to receive the newsletter each quarter, you can easily sign up by clicking “Manage Your Mailing List” in your Provider Portal account. We also recommend that you check your Mailing List periodically to ensure the email addresses for your office are up-to-date.

Our Provider Quick Reference Guide contains helpful contact information and tips and has been updated to v1.5. Download your copy today at https://docs.mcna.net/guides/qrg-tx.

Version 1.27 of the Texas Medicaid and CHIP Provider Manual is now available. This version contains updated Medicaid covered service rates in alignment with the HHSC comprehensive code review effective March 1, 2025. We encourage you to download a copy of the new Texas Provider Manual today at https://manuals.mcna.net/texas.

Version 1.26 of the Texas Medicaid and CHIP Provider Manual is now available. You will find a summary of the changes in the Revision History located at the back of the manual. We encourage you to download a copy of the new Texas Provider Manual today at https://manuals.mcna.net/texas.

Version 1.25 of the Texas Medicaid and CHIP Provider Manual is now available. You will find a summary of the changes in the Revision History located at the back of the manual. We encourage you to download a copy of the new Texas Provider Manual today at https://manuals.mcna.net/texas.