NEMT Medicaid Billing in Texas

Texas runs a split model, and that is the whole story on billing. Fee-for-service riders are covered by the Medical Transportation Program (MTP) under HHSC, and those claims are processed through TMHP — the state's claims processor and MMIS contractor. But most Texas Medicaid enrollees are in managed care — STAR, STAR+PLUS, and STAR Kids — where NEMT is carved into the MCO, and each plan contracts its own broker: Modivcare, MTM, SafeRide Health, or Access2Care, now MTM-owned. Managed-care trips bill through the broker portal, not TMHP. So before a single claim goes out, every trip has to be routed to the right path, matched to the right roster, and filed inside a tight window. Texas gives MTP claims just 95 days from the date of service. This page walks the full cycle — routing, submission, denials, and reconciliation — and shows where we take it off your plate. For the step-by-step portal mechanics of a specific broker, we link down to that broker's billing page.

MTP fee-for-service claims are submitted to TMHP — by portal or EDI from your billing system — and each has to carry the correct level of service, mileage, pickup and drop-off, and dates that match the MTP trip record. Managed-care claims go into each broker portal, MTM Link and the Modivcare, SafeRide, and Access2Care portals, matched to the authorization that portal holds. Mileage on eligible trips is aligned to the IRS rate (72.5 cents per mile effective January 1, 2026) — confirm the current figure with your broker or MTP. Keyed one at a time across four portals plus TMHP, this is where fleets fall behind; batched and checked against each roster first, it is fast and clean. We submit on a set cycle so trips are billed fresh, not weeks later when the 95-day clock is nearly spent.

The last mile is proving you were paid for every trip you ran — and in a split, multi-broker state that means reconciling against several sources at once. MTP payments come back on the TMHP remittance; each managed-care broker pays on its own remittance. Every payment has to be matched to its trip, and the trips that were run but not paid — short-pays, missing claims, silent denials — have to surface instead of disappearing across systems. This is the step fleets skip when they are busy, and with claims spread over TMHP and four broker portals it is exactly where the money leaks. We reconcile every remittance against your trip records, post payments, and chase the gaps, so your revenue matches your operation instead of trailing it.