Texas Medicaid RPM Program Launch Checklist

Launching a Texas Medicaid remote patient monitoring (RPM) program is mostly about getting the authorization, documentation, and workflow pieces in place before the first device ships. Use this checklist so nothing critical is missing. Treat it as a starting framework — adapt the specifics to your agency, and verify current rules with TMHP and your compliance team. This checklist is educational, not billing or legal advice.

1. TMHP authorization readiness

• Confirm your agency is set up to bill Texas Medicaid (TMHP) for RPM.
• Understand the current authorization requirements for S9110 with TMHP.
• Decide how authorization paperwork will be generated, routed, and e-signed.
• Establish where authorization records are stored so they stay audit-ready.

2. Eligible patients and devices

• Define clinical eligibility for the Medicaid patients you’ll start with (for example, hypertension or diabetes).
• Confirm those patients’ Texas Medicaid eligibility and benefits.
• Choose devices that match the conditions you’re monitoring.
• Prefer cellular-connected devices so readings flow in without patient setup steps.
• Plan device fulfillment, onboarding instructions, troubleshooting, and replacement.

3. Digital consent

• Capture and document informed consent before monitoring begins.
• Use a digital consent workflow so consent is stored with the patient record.
• Set patient expectations: how often to take readings, and what happens next.

4. Care-team workflows

• Decide who reviews readings, and on what cadence.
• Configure normal / abnormal / critical thresholds and alerts.
• Create an escalation path that routes urgent findings to the right care manager.
• Set a routine for following up on missed readings and at-risk reading-day counts.
• Tie each patient to a care plan with goals, education, and targets.

5. Reading-day and time tracking

• Capture reading days automatically as device readings arrive.
• Log clinical review and care-management time as the work happens.
• Make sure this evidence is recorded at the source, not reconstructed later.
• Confirm the data supports the modifier you intend to bill each period.

6. S9110 billing readiness

• Verify current S9110 and U1–U9 modifier requirements with TMHP and your compliance team.
• Confirm reading-day and time data rolls up cleanly into a billing export.
• Prepare audit-ready bundle exports that pair each claim with its supporting documentation.
• Establish guardrails against overlapping or conflicting program enrollment.
• Run a small pilot and review the first billing cycle closely before scaling.

7. Launch and iterate

• Train the care team on the tools and workflows before go-live.
• Start with a small cohort of Medicaid patients, then expand once the workflow is smooth.
• Review reading-day compliance, alerts, and outcomes weekly in the early weeks and adjust.

The goal isn’t to do everything at once — it’s to launch a small, well-run Texas Medicaid RPM program you can trust, then grow it on a foundation that already works.