Texas Medicaid STAR Behavioral Health Billing: Enroll, Revalidate and Pick Your Plans
Texas Medicaid STAR behavioral health billing has two separate parts: your enrollment with the state’s claims administrator, and your contracts with the managed care plans that actually pay you. HHSC’s own map lists the managed care plans serving each area, so you usually bill a plan, not the state. If your enrollment lapses, though, nothing else works.
What is Texas Medicaid STAR behavioral health billing, and how does STAR differ from other programs?
STAR is one of the Texas Medicaid managed care programs on the Texas Health and Human Services Commission (HHSC) map, which also lists STAR+PLUS, STAR Kids, STAR Health and the Children’s Health Insurance Program (CHIP). HHSC’s January 2026 service-area map lists which health plans serve each area for each program (HHSC managed care service areas map, revised January 2026). For the state-level overview, see our Texas Medicaid billing page.
Which STAR plans serve my area?
Plans vary by service area. A few examples from HHSC’s map for STAR:
| Service area | STAR plans listed (January 2026) |
|---|---|
| Dallas | Molina, Parkland, Wellpoint |
| Harris | Community Health Choice, Molina, Texas Children’s, United, Wellpoint |
| Travis | Blue Cross and Blue Shield of Texas, Superior, Dell Children’s |
| Bexar | Aetna, Community First, Superior, Wellpoint |
STAR Health is listed statewide with Superior. Always check the map for your own counties. Our Texas insurance contact guide lists plan contact numbers. Enrollment comes first in Texas Medicaid STAR behavioral health billing.
Step 1: How do I enroll in Texas Medicaid?
Enroll through the Texas Medicaid & Healthcare Partnership (TMHP) using its Provider Enrollment and Management System, called PEMS. TMHP says enrolling in Texas Medicaid is a prerequisite for enrolling in other state health-care programs (TMHP provider enrollment). Ask each plan whether it wants your TMHP enrollment confirmed before you contract. Our credentialing page covers the plan-side applications.
Step 2: How do I keep my enrollment active?
Revalidate by your due date, and submit the application, don’t just save it. The Texas Medical Association (TMA) explains that revalidation is complete only at “closed-enrolled” status, a draft saved in PEMS does not count, and an application with unresolved issues past 165 cumulative business days is closed, so you would have to submit a new one (TMA, Medicaid revalidation, updated June 24, 2026).
TMHP also announced extensions effective June 16, 2026. If your due date is on or after June 16, 2026, you submitted the application before the due date and it is still pending, your due date moves out by 60 calendar days (TMHP news, June 11, 2026). Drafts do not qualify.
These are Medicaid rules. Commercial plans have different re-credentialing rules. Verification before the first visit keeps Texas Medicaid STAR behavioral health billing accurate.
What do I do when a Texas Medicaid patient shows up?
Verify coverage and the member’s plan before the first visit. Then bill the plan named on the member’s coverage, following that plan’s rules. Our insurance verification page explains the check, and electronic claims submission covers clean claims.
For policy, the state’s Texas Medicaid Provider Procedures Manual (TMPPM) holds the rules, including the Behavioral Health and Case Management Services Handbook. The October 2026 edition shows “last updated on 9/30/2026” and says it contains all policy changes through October 1, 2026 (TMHP, TMPPM). Use the current edition, not a saved copy.
What do psychiatrists and psychotherapists check?
Psychotherapists should confirm which services each plan covers for your license type, using the plan’s own manual. Review psychotherapy codes 90832, 90834 and 90837 and 90791 and 90792 diagnostic evaluations first.
Psychiatrists bill evaluation and management (E/M) visits, sometimes with psychotherapy add-ons. Ask the plan whether its Medicaid rules match its commercial rules before you assume they do. If you also use home and community codes, see the Medicaid HCPCS guide and the Medicaid billing terms. Plan reviews are one more part of Texas Medicaid STAR behavioral health billing.
Expect plan record reviews
One plan has announced a records review. Blue Cross and Blue Shield of Texas announced an annual quality review of behavioral health records for STAR, CHIP and STAR Kids members. It checks consent, history, treatment plans and discharge plans. The plan says patient authorization is not required for the release, and it does not pay for copying records (BCBSTX news, March 9, 2026). Other plans may run similar reviews.
When a claim denies, follow up quickly using the steps on our denied claims and appeals page.
Common Texas Medicaid mistakes
- Saving a revalidation draft and never submitting it.
- Reading an old copy of the manual instead of the current monthly edition.
- Assuming every plan in your county pays the same way. Each plan sets its own claim rules in its provider manual.
- Treating the HHSC map as permanent. Plan lists are dated; the map you read here was revised in January 2026.
Set a calendar reminder 90 days before your revalidation due date and check PEMS for the status each month. Avoiding these mistakes protects your Texas Medicaid STAR behavioral health billing.
Frequently asked questions
Do I bill the state or a plan for a STAR patient?
Usually the plan. HHSC’s map lists the managed care plans for each area and program.
Does a saved PEMS draft count as revalidating?
No. TMA says a draft does not count; the application must be submitted.
How long is the June 2026 revalidation extension?
60 calendar days, for qualifying pending applications with due dates on or after June 16, 2026, per TMHP.
Where do I find the current Medicaid behavioral health rules?
In the TMPPM’s Behavioral Health and Case Management Services Handbook on TMHP’s site; the October 2026 edition was last updated September 30, 2026.
Where MCM South Medical Billing Service Works
MCM South Medical Billing Service, LLC works with mental and behavioral health practices in ten states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois. Texas is one of them. Founder Michael Williams started the company in 2010 in Georgia and Massachusetts.
If Medicaid enrollment or plan contracting is slowing you down, you can request a free consultation. Our mental health billing FAQ covers more common questions.
