Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 354 - MEDICAID HEALTH SERVICES
Subchapter A - PURCHASED HEALTH SERVICES
Division 1 - MEDICAID PROCEDURES FOR PROVIDERS
Section 354.1001 - Claim Information Requirements
Current through Reg. 50, No. 13; March 28, 2025
(a) Eligible providers are required to provide separate claim information for each eligible recipient. Claims must be complete, accurate, and as specified by the Texas Health and Human Services Commission (HHSC) or its designee.
(b) Required information includes the following:
(c) If the eligible billing provider is a physician supervising the performance of eligible services by a Physician Assistant or an Advanced Practice Registered Nurse (Nurse Practitioner, Clinical Nurse Specialist, or Certified Nurse-Midwife) and the supervising physician did not make a decision regarding the patient's care or treatment on the same date of service as the billable medical visit, the physician must note on the claim, in accordance with standards set by HHSC, that the services were performed by the supervisee.