Texas gives you the shortest Medicaid fuse in the country. Texas Medicaid requires in-state providers to get claims to TMHP within 95 days of the date of service — barely three months, with no grace period. Everything about a Texas billing operation has to be built around that clock.

Medical Billing Services Group supports Texas practices remotely, with a US-based team working inside your existing systems. We serve practices in all 50 states from a single remote operation, and Texas accounts get filing calendars built around the 95-day rule from day one.

Texas Medicaid billing essentials

Texas Medicaid claims are processed by TMHP (Texas Medicaid & Healthcare Partnership) under rules set by the Health and Human Services Commission. The deadlines that govern your revenue:

95 days from date of service. All claims for in-state providers must be received by TMHP within 95 days of the DOS. Out-of-state providers and inpatient claims (measured from discharge) get 365 days — but if you’re a Texas practice, plan on 95.

Medicare crossover: 95 days from Medicare’s decision. For dual-eligible patients, crossover claims must reach TMHP within 95 days of Medicare’s payment or denial. The clock restarts on the Medicare remittance date, which means your crossover workflow needs its own tracking.

Appeals: 120 days. TMHP must receive appeals within 120 days of the remittance date on which the denial appeared. Miss the appeal window and the denial is final regardless of merit.

Texas also runs large managed care programs (STAR, STAR+PLUS, STAR Kids), and each MCO applies the state’s filing framework through its own processes. Newly enrolled providers get a limited accommodation — claims within 95 days of the date the new provider identifier was issued — but that protection is narrow and time-limited.

Where Texas practices lose revenue

The 95-day wall. At 95 days, Texas Medicaid’s window is roughly half of what most states allow. Practices that batch claims weekly instead of daily, or that let eligibility verification lag, run out of runway. A claim that needs one correction cycle can easily age past the deadline.

Crossover timing. Dual-eligible claims are common in Texas, and the 95-day-from-Medicare-decision rule means a slow Medicare adjudication eats your Medicaid window. Without EOB-date tracking, crossover claims die quietly.

Managed care variation. STAR and STAR+PLUS plans layer their own authorization and documentation rules onto the state framework. Denials for missing prior authorization are frequent, and each plan’s appeal path differs.

Enrollment timing. Texas requires providers to meet filing deadlines even while enrollment is pending — and claims for services rendered before the provider identifier is issued face tight submission rules. Our credentialing and payer enrollment service keeps enrollment ahead of your go-live dates.

How MBSG supports Texas practices

We provide full medical billing services and revenue cycle management for Texas practices, including:

• TMHP and MCO claims submission — daily claim cycles built for the 95-day window, with per-payer deadline tracking.
• Denial management — root-cause analysis and appeals filed inside the 120-day window, with corrected-claim workflows that don’t burn the filing clock.
• Eligibility verification and prior authorization — front-end checks that prevent the authorization denials Texas MCOs issue most.
• Medical billing audits — coding reviews targeting the errors behind Texas’s most common denials.
• Clearinghouse connectivity — electronic submission with acceptance reports as proof of timely filing.

Smaller Texas practices can use our small-practice billing support instead of carrying an in-house billing team. Comparing options? See outsourced medical billing.

Specialties we serve in Texas

Billing adapts to specialty coding rules — including behavioral health, cardiology, gastroenterology, oncology, pediatrics, internal medicine, OB-GYN, orthopedic, and urology. Browse all specialties and our services.

Get a Free Billing Audit.

If the 95-day clock, crossover backlogs, or MCO denials are squeezing your Texas practice, start with a Free Billing Audit. We review recent claims and show you exactly where revenue is leaking.

Call +1 (307) 396-4107 or email contact@medicalbillingservicesgroup.com. Pricing is quoted in your written proposal after we review your volume and payer mix — see medical billing pricing. Data is handled under our HIPAA safeguards and business associate agreement (HIPAA & security).

Frequently asked questions

What is the Texas Medicaid timely filing limit?
95 days from the date of service for in-state providers; 365 days for out-of-state providers and inpatient claims measured from discharge. Medicare crossover claims get 95 days from Medicare’s payment or denial. (Confirm against the current TMHP provider manual; rules change.)

Does MBSG have a Texas office?
No. We are a remote company serving all 50 states, working inside your existing EHR and practice management system.

How do you keep claims inside the 95-day window?
Daily claim cycles, per-payer deadline tracking, and a correction workflow designed to turn denials around in days, not weeks.

What happens if we miss the 95-day deadline?
TMHP timely filing denials are rarely overturned, which is why our process is built around prevention — submission-date tracking and clearinghouse acceptance reports on every claim.

Do you handle Texas Medicaid enrollment?
Yes — credentialing and payer enrollment covers TMHP enrollment, MCO contracting, and revalidation.

How do we start?
Get a Free Billing Audit. We analyze your recent claims and denial patterns before you commit to anything.

General educational information, not legal advice or a guarantee of reimbursement. Requirements vary by payer, plan, setting and date of service. Coding references last reviewed 2026-10-08.