How do you become an HCS provider (or host home provider) in Texas?

What are the steps to become an HCS provider in Texas?

There are five main steps: enroll in Texas Medicaid, complete the Provider Applicant Training and exam, apply to HHSC for a contract, receive a provisional contract, and pass the initial certification survey after your first individual enrolls.

HHSC accepts HCS applications year-round through an open enrollment process, on a noncompetitive basis. There is no application deadline.

The agency that holds the HHSC contract is called the program provider. Everyone who delivers services for that agency, including host home providers, works under it.

• Enroll as a Texas Medicaid provider through TMHP's Provider Enrollment and Management System (PEMS)
• Complete the Provider Applicant Training (PAT) online and pass the provider competency exam
• Submit the HCS contract application to HHSC with your PAT certificate
• Receive a provisional contract from HHSC
• Enroll your first individual and pass the initial certification survey

What do you need before you apply?

You need a legal business entity, a National Provider Identifier (NPI), Texas Medicaid enrollment, a qualified program manager, and a passing score on the provider competency exam. HHSC lists each document it expects in the application packet.

Medicaid enrollment comes first. TMHP says applicants must be enrolled as a Texas Medicaid provider through PEMS before they apply for an HCS or TxHmL contract.

The Provider Applicant Training is online through the HHS Learning Portal. It gives an overview of the survey process and covers Medicaid eligibility, program enrollment and utilization review, Life Safety Code, rates, billing, claims, and abuse, neglect, and exploitation. Under 26 TAC §52.31, an applicant must complete the training and score at least 85 percent on the provider competency examination. An applicant that already holds a standard HCS contract in another service area is exempt.

HHSC's page also sets a bar for the program manager: three years of paid work experience providing HCS services to people with an intellectual disability, or three years of similar experience plus proof of microboard membership. The packet includes the manager's resume and three signed, verifiable reference letters.

• NPI verification letter or email
• Employer Identification Number (IRS Form CP-575 or Letter 147C)
• Formation documents for your entity type, such as a certificate of formation or partnership agreement
• Criminal history record receipts for everyone HHSC requires
• Program manager resume and three reference letters
• Your PAT exam certificate

How do you apply for an HCS contract with HHSC?

Apply online through HHSC's Contract Application and Management for Providers (CAMP) portal, or send a paper packet using Form 5873. HHSC's Contract Administration and Provider Monitoring team reviews waiver program applications.

The packet includes Form 3681 (Community Services Contract Application), Form 2031 (Governing Authority Resolution), a data use agreement, and the HHS Information Security and Privacy Initial Inquiry. Forms must be signed by someone with signature authority, and the applicable forms must be notarized.

Plan growth with the interest list in mind. HHSC announced on May 19, 2026, that it "will not release interest list reduction slots for the HCS program starting in May 2026," because HCS appropriations are insufficient to support more slot releases. HHSC has not given a date to resume, so new enrollments from the interest list are limited while the pause lasts.

Keep a copy of everything you submit. HHSC does not publish a processing time on this page, so confirm the current steps with HHSC before you file.

What happens after HHSC approves the contract?

HHSC first awards a provisional contract. HHSC Long-Term Care Regulation (LTCR) then conducts the initial certification survey within 120 days after HHSC approves the enrollment or transfer of the first individual to your agency.

After certification, an HCS provider's certification period is no more than 365 calendar days, and it must be renewed every year. LTCR can also make unannounced visits and surveys.

The HCS Handbook says that if a vendor hold is imposed on a provisional contract, HHSC will initiate termination of the contract. That makes the first survey the one to prepare for most carefully.

The handbook also sets the timeline after a survey. LTCR sends a final report of violations within 14 calendar days after survey exit, and the program provider submits a plan of correction within 14 calendar days of receiving it. Corrective action is due within 30 calendar days after the exit conference for a critical violation, or 45 calendar days for a non-critical violation.

If surveyors identify an immediate threat, the provider must immediately give a plan of removal. If the threat cannot be eliminated, HHSC denies certification.

What must a new HCS agency have in place before the first individual?

Before the first individual moves in, a new agency needs trained and screened staff, written policies, a plan for nursing, and a working record system. The HCS certification standards in 26 TAC Chapter 565 set most of these requirements.

Under 26 TAC §565.9, the program provider must keep trained and qualified service providers continuously available for each individual's needs. It must get a criminal history record before hiring, search the Employee Misconduct Registry and Nurse Aide Registry before hire and every 12 months, and check the federal and Texas exclusion lists before hire and every month.

The same rule requires written policies. They must make sure only staff with a valid driver's license and insurance transport individuals, and they must prevent conflicts of interest, financial impropriety, abuse, neglect, or exploitation, and damage to an individual's possessions.

Plan nursing before you need it. HCS includes registered nursing and licensed vocational nursing services, and the HCS billing rules require nurses to document the exact start and end time of each service event and the medical need behind it.

Records matter from day one. Billing rules require a written service log within 14 calendar days of each service, and the program provider must keep written proof that each service provider is qualified, such as age, education, competency, and references.

• Staff screened: criminal history, registries, and exclusion lists
• Training specific to each individual, done before service begins
• Written policies for transportation, conflicts of interest, finances, and abuse, neglect, and exploitation
• A nurse arrangement and a way to record nursing services
• A record system for service logs, medication records, incidents, and staff files

How do you become a host home or companion care provider in Texas?

A host home or companion care provider does not contract with HHSC directly. The HCS billing rules define a service provider as a staff member, contractor, or volunteer of the program provider, so you work with an HCS program provider that holds the HHSC contract.

Host home/companion care is an HCS residential service. The individual lives in a home that the host home provider or the individual owns or leases, not one the program provider owns or leases. The host home provider must live in the same residence as the individual.

No more than three people in the home can receive host home/companion care or a similar non-HCS service. A minor cannot receive it in a home shared with a parent or the parent's spouse.

To qualify, the host home provider needs a high school diploma or equivalency certificate, or a passed written competency assessment plus written references from three people who are not relatives. The program provider must also keep two documents, such as a photo ID and a lease or utility bill, that show where the provider lives. Under 26 TAC §565.7, training specific to the individual's needs happens before service and at least every 12 months after.

Individuals have a say too. Under 26 TAC §565.9, a program provider must employ or contract with a qualified person the individual or their legally authorized representative chooses, if that person is willing, or document good cause not to.

When should a new agency set up its documentation system?

Set up your documentation system before the first individual enrolls. The initial certification survey reviews records from your first months, and a service log written more than 14 calendar days late does not meet HHSC's billing rules.

Sereniq is the operations and EHR platform for HCS group home and host home providers. DSPs write notes on their phones, and those notes become the Form 4119 or Form 4122 service delivery log, the MAR, and the individual binder a surveyor asks for. Sereniq also tracks staff training and credential expiry dates.

Sereniq was born in Texas on HHSC forms. It keeps the records that support your billing, and it does not submit claims. This guide is not legal advice; confirm every enrollment step and requirement with HHSC.