Medical Billing Services in Texas
Texas practices bill Novitas for Medicare Part A and B, TMHP for fee-for-service Medicaid and a long list of STAR plans for managed care members. We keep each payer's rules and deadlines straight. We support practices in Texas remotely across 15+ specialties.
Who Pays Medical Claims in Texas
The payer groups our team works with every day for Texas practices.
Jurisdiction JH
Texas Medicare Part A and Part B claims go to Novitas Solutions, Inc.. Medicare DME claims go to DME MAC Jurisdiction C (CGS Administrators).
Texas Medicaid
Run by the Texas Health and Human Services Commission (HHSC). Fee-for-service claims and prior authorizations go through the Texas Medicaid & Healthcare Partnership (TMHP).
Managed care plans
Most Texas Medicaid and CHIP members are in managed care: STAR, STAR+PLUS, STAR Kids and STAR Health. Each managed care organization (MCO) has its own claims address, authorization rules and provider portal. We bill and follow up with the state’s Medicaid managed care plans under each plan’s own rules.
Plan lists change. We confirm each patient's current plan at eligibility check. Commercial and Medicare Advantage plans are billed under their own contracts.
Texas Medicaid Billing Rules to Know
Taken from the state program's published provider guidance. Manuals change, so we confirm current rules before each submission.
95-day filing limit
TMHP must receive fee-for-service claims within 95 days of each date of service. A deadline that falls on a weekend or listed holiday moves to the next business day. Late claims are not payable.
120-day appeal window
Appeals must reach TMHP within 120 days of the disposition date on the Remittance and Status (R&S) report the claim appears on.
NPI, taxonomy and benefit code
Paper claims need the NPI and taxonomy code for the billing and performing provider, plus the benefit code (if one applies) and a full ZIP+4 address. Missing items cause a denial.
Source: TMHP Texas Medicaid Provider Procedures Manual, Vol. 1, Section 6 Claims Filing (July 2026).
What Makes Texas Medical Billing Different
What we watch for on Texas accounts.
Why Texas billing gets complicated
The 95-day Texas Medicaid filing limit is far shorter than Medicare's 12 months, so a claim held for a missing note or a coordination-of-benefits question can run out of time quickly. Medicaid members can also move between STAR programs and MCOs, which changes where the claim and the authorization go. That is why charges need to go in clean and early, and our charge entry services are built around that.
What We Handle for Texas Practices
Take the full revenue cycle or just the parts you need help with.
Eligibility and benefits checks before the visit
Prior authorization requests and tracking
Medical coding and charge review
Claim submission to Medicare, Medicaid and commercial payers
Denial management, appeals and A/R follow-up
Payment posting, patient statements and monthly reporting
Specialties We Support in Texas
15+ specialties served. Pick yours to see how we bill it.
Texas Medical Billing Questions
Short answers to questions we hear from practices.
Who processes Medicare Part A and Part B claims in Texas?
Texas is in A/B MAC Jurisdiction H (JH), administered by Novitas Solutions. Medicare DME claims for Texas patients go to the DME MAC for Jurisdiction C, CGS Administrators.
How long do I have to file a Texas Medicaid claim?
For fee-for-service claims, TMHP must receive the claim within 95 days of the date of service, per the Texas Medicaid Provider Procedures Manual. Managed care plans publish their own limits in their provider manuals.
Do STAR managed care plans follow TMHP rules?
Not always. Members in STAR, STAR+PLUS, STAR Kids or STAR Health are covered through their MCO, which sets its own prior authorization and claims process. We check the member's plan before the visit.
Which specialties do you support in Texas?
We support 15+ specialties, including behavioral health, laboratory, home health, hospice, infusion, sleep medicine, DME, dental, vision and ENT.
Can Salyx RCM handle billing for my Texas practice remotely?
Yes. We support practices in Texas remotely, working inside your practice management or billing software with secure access.
See Where Your Texas Claims Are Getting Stuck
Start with a free billing audit. We review your recent claims, denials and A/R, then tell you what we found.