What Is the Texas Standardized Credentialing Application (TSCA)?

The Texas Standardized Credentialing Application, widely known as the TSCA, is the official state-mandated credentialing form used by hospitals, Health Maintenance Organizations (HMOs), and Preferred Provider Organizations (PPOs) in Texas to verify the qualifications of physicians and other healthcare providers.

The TSCA is not optional. Its use is required under Texas Insurance Code Chapter 1452, which was enacted through Senate Bill 544 (77th Texas Legislature, effective September 1, 2001). The Texas Department of Insurance promulgated the form under LHL234 Rev. 01/07. Any hospital, HMO, or PPO operating in Texas must use this form for physician credentialing. Other healthcare organizations may also use it for credentialing allied health professionals.

The form is based on the application originally developed by the Coalition for Affordable Quality Healthcare (CAQH) and is specifically adapted for Texas regulatory requirements. Providers submit the completed TSCA directly to each health benefit plan or workers' compensation network with which they want to become a participating provider.

 

Who Needs to Complete the TSCA?

The TSCA applies to a wide range of healthcare providers seeking to practice within Texas-regulated health networks. The following provider types are required to complete it:

Physicians (MDs and DOs) — all hospitals, HMOs, and PPOs in Texas are legally required to use the TSCA for physician credentialing. There are no exceptions to this requirement.

Nurse Practitioners and Physician Assistants — health plans in Texas may use the TSCA for credentialing these providers. Most major Texas payers now require it.

Mental and Behavioral Health Providers — psychologists, licensed clinical social workers, marriage and family therapists, and licensed professional counselors credentialing with Texas health plans are expected to complete the TSCA or a TSCA-equivalent application.

Allied Health Professionals — physical therapists, occupational therapists, speech-language pathologists, chiropractors, and other allied health providers may be required to complete the TSCA depending on the specific health plan.

Group Practices — each individual provider within a group practice must complete a separate TSCA. The group's organizational information is typically submitted through an accompanying group application or roster, but individual TSCA submissions are still required for every licensed clinician in the group.

 

Where to Get the TSCA Form

The official TSCA (Form LHL234) is available directly from the Texas Department of Insurance at:

https://www.tdi.texas.gov/hmo/crform.html

The form is available as an interactive PDF and in several downloadable formats. When using the interactive PDF version, note that information typed into the free version of Adobe Acrobat Reader is not saved when the file is closed. Always save the form to your computer before opening it, and print a copy before closing the form to preserve your entries.

Providers with an active CAQH ProView profile can also download a pre-populated version of the TSCA directly from CAQH. The format changes slightly per payer, but the underlying information requirements are nearly identical to a standard CAQH application. Using CAQH to pre-fill the TSCA saves significant time and reduces data entry errors.

 

TSCA vs. CAQH ProView — What Is the Difference?

This is one of the most common questions Texas providers ask during credentialing. The distinction is important.

CAQH ProView is a national centralized database used by over 900 health plans across the United States. It allows providers to submit their professional information once and share it with multiple payers. Most Texas commercial payers — including BCBS Texas, Aetna, Cigna, UnitedHealthcare, Humana, and Molina — use CAQH as a primary data source during credentialing.

The TSCA is the Texas state-specific form mandated by the Texas Department of Insurance. It is used primarily for hospital privileging and for credentialing with HMOs and PPOs that operate under Texas Insurance Code requirements.

In practice, many Texas providers need both. CAQH handles commercial payer enrollment applications. The TSCA is specifically required for hospital credentialing committees, HMO participation, and PPO network enrollment under Texas state law.

The good news is that the information required by the TSCA overlaps significantly with CAQH ProView. A provider with a complete and current CAQH profile can typically complete the TSCA much faster using exported CAQH data. Keeping CAQH current is the single most efficient way to maintain TSCA readiness.

 

The 10 Sections of the TSCA — What You Need to Complete

The TSCA is organized into ten core sections. Understanding what each section requires before you begin saves time and prevents the back-and-forth that delays approvals.

Section I — Individual Information Your full legal name exactly as it appears on your Texas medical license, professional type (MD, DO, PA, NP, etc.), contact information, practice address, and billing address. Your name must match your NPI registration in NPPES exactly. Any mismatch between your TSCA, your Texas Medical Board license, your NPPES record, and your CAQH profile triggers manual review at the payer level.

Section II — Education and Training All medical education from undergraduate through graduate and professional school. Include institution names, cities, states, countries, degree types, and attendance dates. Internship, residency, and fellowship training must be listed with no unexplained gaps. Gaps of more than 30 days without explanation are flagged during primary source verification and require a written explanation.

Section III — Board Certification Current and past board certifications, certifying board names, initial certification dates, and recertification dates. If you are board-eligible but not yet board-certified, indicate this clearly. Omitting this section or leaving it incomplete is one of the most frequent causes of TSCA processing delays.

Section IV — Texas Medical License and Other State Licenses Your current Texas Medical Board license number, issue date, expiration date, and license type. All other state medical licenses you hold, including license numbers and expiration dates. License status is verified directly with the Texas Medical Board during primary source verification — there is no proxy for this step.

Section V — DEA Registration Your current DEA registration number, issue date, expiration date, and registered address. If you hold DEA registrations in multiple states, list all of them. If your specialty does not require a DEA registration, indicate this clearly rather than leaving the section blank. A blank DEA section without explanation causes processing delays.

Section VI — Hospital Affiliations and Privileges Every hospital, ambulatory surgery center, and healthcare facility where you currently hold active clinical privileges. For each facility, include the facility name, address, department, privilege type, and dates of appointment. For BCBS Texas applications specifically, missing even one current hospital affiliation results in a returned application. List every facility where you see patients.

Section VII — Professional Work History A minimum of five years of professional work history with no unexplained gaps of more than 30 days. Include employer names, addresses, employment dates, your title or role, and a brief description of your responsibilities. This section is cross-referenced against your malpractice claims history and your CAQH profile — inconsistencies between these records are flagged and require clarification.

Section VIII — Malpractice Insurance Your current professional liability insurance carrier, policy number, coverage dates, coverage limits per occurrence and aggregate, and mailing address for your carrier. Your malpractice carrier will be contacted directly for verification. Ensure your coverage is active and that your policy limits meet the minimum requirements of each payer you are applying to. BCBS Texas has specific minimum coverage requirements for Texas providers.

Section IX — Professional Liability Claims History A complete disclosure of all past and pending malpractice claims, settlements, judgments, and arbitrations. This section is verified against the National Practitioner Data Bank (NPDB). Omitting or understating claims history is one of the most serious credentialing errors a provider can make. Full, accurate disclosure is required. Credentialing committees understand that claims exist in medical practice — what they scrutinize is whether your disclosure is consistent with the NPDB report.

Section X — Attestation Your signed declaration that all information provided in the application is accurate, complete, and current as of the date of submission. Signing this section carries legal weight. Review every section carefully before signing. Any errors discovered after submission require a corrected submission, which restarts primary source verification for the affected sections.

 

Documents Required With the TSCA

The TSCA application itself is the form, but credentialing committees require supporting documentation for every credential you list. Prepare the following before submitting:

A copy of your current Texas Medical Board license, showing the license number and expiration date. A copy of your current DEA registration certificate, if applicable. A copy of your board certification certificate or your board eligibility letter. A copy of your current malpractice insurance face sheet showing coverage dates, limits, and carrier name. A copy of your medical school diploma. A copy of your residency completion certificate or training verification letter. A copy of your fellowship completion certificate, if applicable. Your current CAQH ProView profile number and attestation date. Your current NPI number (Type 1 individual NPI). For group submissions, the group NPI (Type 2) and an updated provider roster.

All documents should be current at the time of submission. Documents that expire during the credentialing window must be renewed and resubmitted immediately, or the application stops until renewal is confirmed.

 

How the TSCA Fits Into the Texas Credentialing Process

The TSCA is one step in a multi-stage credentialing process. Understanding where it fits helps providers plan their timeline more accurately.

Step 1 — NPI Registration Before any credentialing application can be submitted, providers must have an active National Provider Identifier (NPI) registered in NPPES. Your Type 1 (individual) NPI must be active, and the taxonomy code associated with it must match your primary specialty. NPI taxonomy mismatches between NPPES and payer records cause claim denials that appear months after credentialing appears complete.

Step 2 — CAQH ProView Setup Most Texas payers require an active CAQH ProView profile. CAQH is used as a primary data source for commercial payer credentialing, and the TSCA can be largely pre-populated from CAQH data. Complete all 18 sections of your CAQH profile before submitting any credentialing applications. Incomplete CAQH profiles are the leading cause of preventable credentialing delays in Texas. CAQH attestation must be current — attestation that expires mid-application can result in application termination by certain payers.

Step 3 — Texas Medical Board License Verification The Texas Medical Board is a primary source for license verification. Your license must be active and in good standing before any Texas credentialing application can be processed. If your license has any restrictions, conditions, or disciplinary history, this information will appear during primary source verification and must be disclosed in your TSCA.

Step 4 — TSCA Submission Submit a completed TSCA directly to each hospital, HMO, or PPO you are applying to. For most commercial payers, your CAQH profile serves as the credentialing application, and the TSCA is submitted specifically for hospital privileging and HMO or PPO enrollment under Texas Insurance Code requirements.

Step 5 — Primary Source Verification After submission, the credentialing organization contacts every primary source listed in your TSCA to verify each credential. This includes your medical school, residency program, fellowship program, state licensing boards, DEA, board certification bodies, malpractice carrier, and the National Practitioner Data Bank. Under NCQA 2025 standards, which remain effective through June 2026, accredited organizations must complete primary source verification within 120 days. Certified organizations must complete it within 90 days.

Step 6 — Credentialing Committee Review After primary source verification is complete, a credentialing committee reviews the file and makes an approval, denial, or provisional decision. This committee typically meets on a monthly schedule at most hospitals and HMOs. If your file misses the committee meeting cycle, you wait until the next meeting — which can add 30 to 60 days to your timeline.

Step 7 — Notification and Effective Date Once the committee approves your application, you receive written notification and an effective date. You cannot bill as an in-network provider until the effective date stated in your approval letter. Billing before the effective date creates compliance risks regardless of when you saw the patient.

 

Most Common TSCA Errors That Cause Delays

These are the errors that Texas providers encounter most often during TSCA submission. Each one is preventable.

Name mismatch across records. Your name on the TSCA must match your Texas Medical Board license, your NPPES registration, your CAQH profile, your DEA certificate, and your malpractice insurance face sheet exactly. Even minor differences — a middle initial included in one record but not another — trigger manual review.

Unexplained work history gaps. Any gap of more than 30 days in your professional work history must be explained in writing. Common acceptable explanations include parental leave, illness, research, travel, or transition between positions. Unexplained gaps cause the application to pause while the credentialing organization requests clarification.

Incomplete hospital affiliations. Every facility where you currently hold active privileges must be listed. Missing a facility means the application comes back for correction.

Outdated or expiring documents. Licenses, DEA certificates, board certifications, and malpractice policies that expire during the credentialing window must be renewed and resubmitted immediately. Applications stop processing when a credential expires until renewal documentation is received.

Incomplete CAQH attestation. If your CAQH profile is not currently attested, it is not accessible to payers — even if every section is filled in. Attestation is the legal certification that your profile is accurate and complete. Some Texas payers have specific CAQH attestation deadlines. Missing these deadlines requires restarting the credentialing process from the beginning.

Wrong NPI type. Individual providers use a Type 1 NPI. Group practices use a Type 2 NPI for the practice entity plus a Type 1 NPI for each individual provider. Submitting the wrong NPI type results in a returned application.

Malpractice disclosure inconsistencies. Any malpractice history disclosed in your TSCA is cross-referenced against the National Practitioner Data Bank. Discrepancies between what you disclose and what the NPDB report shows are treated as serious credentialing concerns. Full and accurate disclosure is always the correct approach.

 

TSCA Requirements for Specific Texas Payers

While the TSCA is a standardized form, individual Texas payers have requirements that go beyond the base form.

BCBS Texas requires current roster template version 25.11.22 or newer for group submissions as of February 2026. Applications submitted on older templates are automatically rejected. BCBS Texas also requires CAQH attestation to be finalized within 45 days of application initiation. Failure to attest within this window results in application termination and a full restart.

TMHP (Texas Medicaid) requires TSCA-equivalent information submitted through the PEMS portal, but providers must complete PEMS enrollment before submitting to any Texas Medicaid managed care organization. The TSCA alone does not complete Texas Medicaid enrollment — PEMS enrollment is a required separate step.

Molina Healthcare of Texas explicitly requires providers to complete the TSCA or provide their CAQH ProView number along with current attestation. CAQH attestation at Molina must not be older than 30 days at the time of application review.

HMOs operating under Texas Insurance Code Chapter 1452 are legally required to use the TSCA for physician credentialing without exception. There is no alternative form accepted by these organizations for this purpose.

 

TSCA for Re-Credentialing in Texas

Re-credentialing is not a one-time event. Texas providers must complete re-credentialing on a schedule determined by each organization. Most Texas commercial payers require re-credentialing every two to three years. Hospital credentialing committees typically require annual review. The Texas Medical Board issues licenses on a two-year renewal cycle. DEA registrations must be renewed every three years.

Re-credentialing uses the same TSCA form and documentation requirements as initial credentialing. The risk during re-credentialing is not the process itself — it is allowing credentials to lapse. A credentialing lapse removes you from the payer's active provider list. Retroactive reinstatement is not guaranteed, and revenue lost during a lapse period is not recoverable.

Begin re-credentialing preparation at least 90 to 120 days before any credential expiration. This includes your Texas Medical Board license, DEA registration, board certifications, malpractice policy, and all payer contracts. A single lapsed credential can pause the entire re-credentialing process and create a gap in your billing eligibility.

 

TSCA for New Physicians Starting a Practice in Texas

New physicians starting a practice in Texas face a more complex credentialing landscape than those joining an existing group because they are establishing all payer relationships simultaneously.

The recommended sequence for new Texas physicians is:

First, obtain your NPI and ensure your taxonomy code is correct in NPPES. Second, complete your Texas Medical Board license application and confirm active licensure. Third, obtain your DEA registration if your specialty requires controlled substance prescribing. Fourth, complete your CAQH ProView profile across all 18 sections and attest. Fifth, submit your TMHP enrollment through PEMS if you will be seeing Medicaid patients — TMHP enrollment must precede MCO enrollment. Sixth, submit your Medicare enrollment through PECOS if you will be billing Medicare. Seventh, submit your TSCA and commercial payer applications simultaneously, not sequentially.

The most common mistake new Texas physicians make is submitting payer applications one at a time in sequence. Every application tracks separately. Submitting all target payer applications simultaneously means your Medicare, TMHP, and commercial payer credentialing run in parallel from day one — not in a chain that adds months to your total timeline.

 

Frequently Asked Questions

What is the Texas Standardized Credentialing Application (TSCA)?

The TSCA (Form LHL234) is a state-mandated credentialing form required by Texas Insurance Code Chapter 1452. All hospitals, HMOs, and PPOs in Texas must use it to verify physician credentials. It is promulgated by the Texas Department of Insurance and available at tdi.texas.gov.

Is the TSCA the same as CAQH?

No. CAQH ProView is a national centralized database used by commercial payers across the United States. The TSCA is a Texas state-specific form mandated for hospital and HMO credentialing under Texas law. Most Texas providers need both. CAQH data can be used to pre-populate the TSCA, which is why keeping your CAQH profile complete and attested is critical.

Do nurse practitioners need to complete the TSCA in Texas?

Most Texas health plans require nurse practitioners to complete the TSCA or a TSCA-equivalent application. While the legal mandate in Texas Insurance Code Chapter 1452 specifically requires hospitals, HMOs, and PPOs to use it for physician credentialing, the same organizations may require it for NPs and PAs at their discretion — and most do.

How long does TSCA-based credentialing take in Texas?

Hospital credentialing using the TSCA typically takes 90 to 120 days. This timeline assumes a complete, error-free application with all supporting documents submitted at once. Missing documents, name mismatches, or unexplained work history gaps extend this timeline significantly. Committee review schedules — most hospitals hold monthly credentialing committee meetings — can add 30 to 60 days if your file misses a meeting cycle.

Where do I send the completed TSCA?

The completed TSCA is sent directly to the health benefit plan, hospital, HMO, PPO, or workers' compensation network with which you want to become a participating provider. There is no central submission location — each organization receives its own application. Contact each organization's credentialing department for submission instructions before sending.

What happens if my TSCA has an error?

Errors on a submitted TSCA result in the application being returned for correction. Once you correct and resubmit, primary source verification restarts for the affected sections. This can add 30 to 60 days to your credentialing timeline. Reviewing every section for accuracy before submission — and ensuring consistency with your Texas Medical Board license, NPPES record, CAQH profile, and DEA certificate — is the most effective way to prevent this.

Can I use the same TSCA for multiple payers?

The TSCA is a standardized form, but each payer may have specific supplemental requirements. You submit the TSCA directly to each individual organization rather than submitting one application to a central clearinghouse. Some payers accept your CAQH ProView profile in lieu of a separately completed TSCA — confirm this with each payer's credentialing department before submission.

What is the NPI requirement for Texas credentialing?

As of September 1, 2021, the NPI is the only accepted identifier for Texas Medicaid credentialing. Texas stopped issuing Medicaid identification numbers (formerly known as TPI numbers) on that date. For all Texas credentialing applications, use your Type 1 NPI (individual provider) and ensure your taxonomy codes in NPPES are accurate and match your primary specialty.

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