TX HHS Form 1090. Oral Evaluation and Fluoride Varnish Certification Application

The Texas Health and Human Services (HHS) Form 1090 is an oral evaluation and fluoride varnish certification application designed for healthcare providers. This form serves as a tool for professionals to demonstrate their competence in performing oral evaluations and applying fluoride varnish to patients.

This application is intended for use by dental professionals, including individual providers and group/facility representatives. The form requires providers to submit their National Provider Identifier (NPI) number, Texas Health Steps (THSteps) personal TP! number, and other relevant information. By completing this form, providers can obtain certification in oral evaluation and fluoride varnish application, enabling them to bill Medicaid for these services.

The Form 1090 is issued by the Texas HHS and must be submitted along with a CE certificate via email or fax. The submission process allows providers to demonstrate their commitment to delivering high-quality healthcare services while ensuring compliance with Medicaid billing requirements. By using this form, providers can streamline their certification process and maintain accurate records of their training and certifications.