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 12 - RURAL HEALTH CLINICS
Section 354.1202 - Conditions for Payments to Rural Health Clinics

Universal Citation: 1 TX Admin Code ยง 354.1202

Current through Reg. 49, No. 38; September 20, 2024

The department will reimburse rural health clinics for services provided to eligible recipients under the following conditions:

(1) To receive payment for rural health clinic services as defined in § 29.1201 of this title (relating to Authorized Services by Rural Health Clinics), the following conditions must be met:

(A) the rural health clinic must contract with the department to become a provider of rural health clinic services;

(B) the rural health clinic must provide reports and other information specified by the department or its authorized representative;

(C) rural health clinic personnel providing primary health care must be licensed in Texas or in the state within the United States in which and at the time and place the service(s) is provided and/or meet all other established qualifications; and

(D) the rural health clinic must be certified and participate under Title XVIII of the Social Security Act.

(2) To receive payment for other ambulatory services as defined in § 29.1201 of this title (relating to Authorized Services by Rural Health Clinics), the following conditions must be met:

(A) the rural health clinic must meet the same conditions of participation as any other provider of the same service(s);

(B) the rural health clinic must meet the same qualifications and be subject to the same limitations and exclusions in the amount, duration, and scope of benefits as any other provider of the same service(s); and

(C) the rural health clinic must meet all the same requirements of the federal and state laws or regulations with regard to a particular service as all other providers of that same service who provide the service in a setting other than a rural health clinic.

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