Texas Medicaid health plans: which ones serve your area and how to join each for behavioral health

Part of our credentialing guide for Texas practices and programs. Start with TMHP enrollment if you haven't enrolled yet.

The three layers: TMHP, the CVO, each plan

Layer	What happens	Who runs it
1. State enrollment	You enroll in Texas Medicaid in PEMS and get a Texas Provider Identifier. Lets you bill traditional Medicaid only.	TMHP, for HHSC
2. Verification	Primary-source checks of license, education, sanctions and history, done once and shared with every Medicaid plan.	The Texas CVO, managed by the Texas Association of Health Plans (Verisys)
3. Each plan	The plan's application, its credentialing committee, and the contract with your rates and effective date.	Each MCO you choose

TAHP describes the order as enrollment with TMHP, credentialing through the CVO, then contracting with the MCOs (TAHP's Credentialing 101). The centralized CVO started April 1, 2018, and every Medicaid MCO must use it whether or not it belongs to TAHP (TAHP's 2024 presentation to HHSC's managed care advisory committee). Skipping layer 1 stops everything: no Texas Medicaid plan will credential a provider who isn't enrolled with TMHP.

Plans by service area

HHSC lists 17 MCOs serving Medicaid and CHIP members (HHSC's managed care overview), and assigns them by service area, a group of counties. The authoritative list is HHSC's managed care service areas map. Here is what it showed for STAR and CHIP in these areas when we checked; for Dallas, Tarrant, Jefferson, the rural areas, and for STAR+PLUS and STAR Kids everywhere, open the map.

Service area	STAR plans	CHIP plans
Harris (Houston)	Community Health Choice, Molina, Texas Children's, UnitedHealthcare, Wellpoint	The same five
Bexar (San Antonio)	Aetna Better Health, Community First, Superior, Wellpoint	The same four
Travis (Austin)	Blue Cross and Blue Shield of Texas, Dell Children's, Superior	See the map (UnitedHealthcare also appears for STAR+PLUS)
Hidalgo (Rio Grande Valley)	Driscoll, Molina, Superior, UnitedHealthcare	Molina, Superior
Nueces (Corpus Christi)	Driscoll, Superior, UnitedHealthcare	The same three
El Paso	El Paso Health, Molina, Superior	El Paso Health, Superior
Lubbock	FirstCare, Superior, Wellpoint	FirstCare, Superior
Dallas, Tarrant, Jefferson and the rural areas	Check the map. Local plans include Parkland Community Health Plan (Dallas) and Cook Children's Health Plan (Tarrant).	Check the map

STAR Health, for children in foster care, is one statewide plan: Superior HealthPlan. STAR+PLUS (adults with disabilities and adults 65 and older) and STAR Kids have their own line-ups in each area.

Plan by plan

What each plan's own materials say about joining, and what to ask. Where a plan uses a separate company for behavioral health, you join that company's network instead; our sister site explains behavioral health carve-outs.

Superior HealthPlan (Centene)

STAR, STAR+PLUS, STAR Kids, CHIP, STAR Health statewide; Ambetter marketplace

Network Participation Request first (Superior allows up to 30 days to answer), CAQH for clinicians, its own Behavioral Health Facility and Ancillary Credentialing Application for programs. Behavioral health is handled in house. Full walk-through: Superior HealthPlan credentialing.

Wellpoint Texas (formerly Amerigroup)

STAR, STAR+PLUS, STAR Kids, CHIP in its awarded areas

A Request for Credentialing / Letter of Interest form with a W-9 for new providers; Availity Essentials for clinicians joining a contracted group; MultiPlan's Texas True Choice network in the rural service area. Full walk-through: Wellpoint Texas credentialing.

Molina Healthcare of Texas

STAR, STAR+PLUS and CHIP in several areas

Molina's Texas Medicaid and CHIP provider manual says its credentialing department verifies everything on the provider application before contracting and re-verifies it every three years (or sooner under its criteria), then presents the file to its Professional Review Committee. The same manual says Molina manages all covered behavioral health services itself, so there's no separate behavioral health company to join, and it has chapters on expedited credentialing and your appeal rights (Molina Texas provider manual). Molina has also published Texas marketplace provider materials with a separate contracting mailbox for that network (Molina marketplace quick reference guide); ask which products your contract covers.

UnitedHealthcare Community Plan of Texas

STAR and STAR+PLUS in several areas

Behavioral health runs through Optum, so behavioral health clinicians and programs join through Optum's network process rather than UnitedHealthcare's medical one. Confirm which network your contract covers (Medicaid, commercial or both).

Blue Cross and Blue Shield of Texas Medicaid

STAR and CHIP in the Travis area; STAR Kids in some areas

BCBSTX's Medicaid network has its own Medicaid network participation page, separate from its commercial network. Our BCBS of Texas guide covers the Provider Record ID and the commercial side.

Aetna Better Health of Texas

STAR and CHIP in Bexar; other areas per the map

Aetna Better Health says it offers mental health and SUD PHP and IOP to STAR members in lieu of inpatient psychiatric care (Aetna Better Health in-lieu-of services notice), which matters for programs. Aetna Better Health is credentialed separately from Aetna's commercial network; see our Aetna guide for the commercial side.

Community Health Choice

STAR and CHIP in Harris

A Houston-area plan that is part of the Harris Health System. Its provider resources page carries its forms and CVO notices, and it reminded LPCs and LMFTs in 2024 that they must enroll in Medicare before Texas Medicaid.

Texas Children's Health Plan

Harris and Southeast Texas; mostly children and pregnant women

Publishes provider alerts on in-lieu-of services (Texas Children's in-lieu-of services alert) and a PEMS revalidation FAQ. Most relevant to programs that treat children, teens and pregnant women.

Local and children's plans

Community First Health Plans (Bexar), Driscoll Health Plan (Hidalgo and Nueces), El Paso Health (El Paso), FirstCare (Lubbock), Dell Children's Health Plan (Travis), Parkland Community Health Plan (Dallas) and Cook Children's Health Plan (Tarrant) each serve their own area. Children's plans enroll mostly children, so weigh them by the clients you treat. All use the same CVO; each has its own application on its provider site.

Which plans to apply to first

1. List your counties and find each one's service area on HHSC's map.
2. Match programs to your clients. STAR covers most children, pregnant women and some families; STAR+PLUS covers adults with disabilities and adults 65 and older; STAR Kids covers children and young adults with disabilities; CHIP covers children whose families earn too much for Medicaid; foster youth are in STAR Health. An adult SUD IOP mostly needs the STAR and STAR+PLUS plans; an adolescent program needs STAR, CHIP and the children's plans.
3. Start with two or three plans serving those programs in your area, and ask each whether its behavioral health panel is open before you file.
4. For a program, ask whether each plan offers adult PHP and IOP as in-lieu-of services and how it pays them before you count on the revenue (our Texas Medicaid IOP and PHP guide explains).
5. Add plans later as referral sources tell you which cards your clients carry.

The forms: clinicians and facilities

• Clinicians: most Texas Medicaid plans read your CAQH ProView profile, so finish and attest it first (our CAQH ProView guide). Texas also has a Texas Standardized Credentialing Application; the Texas Department of Insurance rule requires HMOs and PPOs to use it for physicians, advanced practice nurses and physician assistants (28 TAC §21.3201), and some plans accept it for other clinicians who file on paper.
• Facilities and programs: TAHP publishes a Texas Facility/Ancillary/Long-term Care Credentialing Application, and its instructions warn that changing its wording or format invalidates it (TAHP facility application). Availity is the online facility application portal for the TAHP plans (CVO training deck). Some plans, like Superior, also use their own facility form; ask which one each plan wants.
• Attachments a program needs: the HHSC license for each site, the TMHP enrollment letter, the accreditation letter if you have one, liability certificates, the ownership disclosure, a roster and a W-9. Our credentialing documents checklist lists everything.

Expedited credentialing

Texas law requires every Medicaid MCO to run an expedited credentialing process that lets certain providers serve members provisionally while credentialing finishes (Government Code §540.0656; 1 TAC §353.423). The applicant must belong to an established group that already has a contract with the MCO, be enrolled in Texas Medicaid, agree to the group contract's terms and send what the MCO requires on time. Superior's guide lists LCSWs, LPCs, LMFTs and psychologists among the eligible behavioral health types. Plans can recover payments from a provider who turns out not to meet their credentialing requirements and submitted fraudulent claims, so use it for clean files only.

Recredentialing, appeals and upkeep

• Recredentialing: plans re-verify on a cycle; Molina's manual says every three years. Keep CAQH attested every 120 days so the CVO has current documents.
• TMHP revalidation: at least every five years in PEMS; a missed one disenrolls you from every plan at once. See our Texas Medicaid guide.
• Denied? Ask for the reason in writing and the plan's appeal steps (Molina's manual has a chapter on them). A closed panel is a different problem; our closed network guide covers it.
• Roster changes go to every plan when a clinician joins or leaves, or claims for that clinician deny.

What we do and what it costs

Our credentialing service enrolls you with TMHP, picks the plans for your counties, files each application, follows up every two weeks, reviews each contract and confirms each effective date in writing. Texas Medicaid enrollment with your first plan is $350 per clinician; each more plan is $175 per plan for a clinician or $450 per plan for a program's facility contract. On our Texas roadmaps, the plan applications wait for TMHP and a finished CAQH profile, and we budget about 90 days for them.

Service	Price
Medicaid enrollment State Medicaid enrollment and the first managed care plan. Includes: State enrollment (Texas: TMHP); One Medicaid managed care plan; Revalidation date tracked.	$350 per clinician
Credentialing: one insurance plan One clinician with one insurance plan, from application to effective date. Includes: Application filed; Follow-up every 2 weeks until decided; Contract review checklist (rates, timely filing, termination); Effective date confirmed and loaded in your EHR.	$175 per plan
Facility or group contract: one plan A program or group contract with one insurance plan: the organization application, site visit and contract. Includes: Organization application; Site visit preparation if the plan does one; Contract and rate review checklist; Effective date and billing set-up confirmed.	$450 per plan

For example, a new SUD program in the Harris area applying to TMHP and three Medicaid plans as a facility: $1,250. Check your own numbers with the credentialing cost calculator, or have the whole sequence carried in the IOP / PHP Program Launch.

Questions

How many Medicaid managed care plans are there in Texas?

HHSC lists 17 MCOs for Medicaid and CHIP (plus three dental plans). Each serves only certain service areas, so a provider usually chooses among three to five in its area.

Do I have to credential with every Texas Medicaid plan?

No. Join the plans that serve your counties and the clients you treat. Start with two or three and add more as you learn which cards your clients carry.

Is there one credentialing application for all Texas Medicaid plans?

No. There's one shared verification (the Texas CVO), but each plan has its own application, committee and contract. The CVO saves you from repeating the document checks.

Can I join a Texas Medicaid plan before TMHP approves me?

No. TMHP enrollment comes first; the plans credential providers who are already enrolled in Texas Medicaid.

Which Texas Medicaid plan covers foster children?

STAR Health, which is one statewide plan run by Superior HealthPlan.

How do I find which plans serve my county?

Use HHSC's managed care service areas map. It lists the plans for STAR, STAR+PLUS, STAR Kids and CHIP in each service area.

More Texas plan guides: Superior HealthPlan · Wellpoint Texas · Texas Medicaid for IOP and PHP · How long credentialing takes

Sources

All checked October 24, 2026. HHSC changes plan line-ups with its contracts; open the current map before you rely on any row.

1. Texas HHSC, Managed Care Service Areas map. hhs.texas.gov
2. Texas HHSC, Medicaid and CHIP managed care overview (17 MCOs). hhs.texas.gov
3. Texas Association of Health Plans, "Credentialing 101," Fall 2024. tahp.org
4. Texas Association of Health Plans, credentialing presentation to the State Medicaid Managed Care Advisory Committee, February 2024. tahp.org
5. Texas Association of Health Plans, Texas Facility/Ancillary/Long-term Care Credentialing Application, 2023. tahp.org
6. Aetna Better Health of Texas, CVO training (Availity facility application portal for TAHP plans). aetnabetterhealth.com
7. 28 Tex. Admin. Code §21.3201, Texas Standardized Credentialing Application. law.cornell.edu
8. Texas Government Code §540.0656, Expedited Credentialing Process for Certain Providers. law.justia.com
9. 1 Tex. Admin. Code §353.423, Expedited Credentialing. law.cornell.edu
10. Superior HealthPlan, Expedited Credentialing guide. superiorhealthplan.com
11. Molina Healthcare of Texas, Medicaid/CHIP/MMP Provider Manual, 2024. molinahealthcare.com
12. Molina Healthcare of Texas, Marketplace Quick Reference Guide. molinahealthcare.com
13. Blue Cross and Blue Shield of Texas, Medicaid Network Participation. bcbstx.com
14. Aetna Better Health of Texas, In-Lieu-Of Services: Adult PHP and IOP. aetnabetterhealth.com
15. Community Health Choice, Provider Resources. communityhealthchoice.org
16. Community Health Choice, "Reminder: LPC and LMFT Providers Must Enroll in Medicare Effective 03/01/2024." communityhealthchoice.org
17. Texas Children's Health Plan, "In-Lieu-Of Services" provider alert. texaschildrenshealthplan.org

This guide is general information. Cima Consulting isn't a law firm or an accounting firm. HHSC, TMHP and each health plan make their own decisions; we don't guarantee approvals, rates or dates. We aren't affiliated with any health plan named here.