Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 354 - MEDICAID HEALTH SERVICES
Subchapter O - ELECTRONIC VISIT VERIFICATION
Section 354.4005 - Personal Care Services that Require the Use of EVV

Universal Citation: 1 TX Admin Code ยง 354.4005

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

(a) A program provider must ensure a service provider uses EVV to document the provision of the following personal care services by the program provider:

(1) in the traditional Medicaid service model also referred to as fee-for-service, including for members enrolled in STAR who receive PCS through fee-for-service:
(A) CFC PAS;

(B) CFC HAB;

(C) PCS provided under Texas Health Steps CCP, including SRO; and

(D) PCS-Behavioral Health provided under Texas Health Steps CCP, including SRO;

(2) in the CLASS Program:
(A) CFC PAS/HAB; and

(B) in-home respite;

(3) personal attendant services provided through the Community Attendant Services Program, including SRO;

(4) in the DBMD Program:
(A) CFC PAS/HAB; and

(B) in-home respite;

(5) personal attendant services provided through the FC Program, including SRO;

(6) in the HCBS-AMH Program:
(A) supported home living; and

(B) in-home respite;

(7) in the HCS Program:
(A) CFC PAS/HAB;

(B) in-home respite; and

(C) in-home individualized skills and socialization provided to members with the residential type of "own/family home";

(8) personal attendant services provided through the Primary Home Care Program, including SRO;

(9) in the STAR Health Program:
(A) CFC PAS, including SRO;

(B) CFC HAB, including SRO; and

(C) for a member in STAR Health MDCP:
(i) in-home respite, with and without RN delegation, including SRO; and

(ii) flexible family support, with and without RN delegation, including SRO;

(10) in the STAR Kids Program:
(A) CFC PAS, including SRO;

(B) CFC HAB, including SRO; and

(C) for a member in STAR Kids MDCP:
(i) in-home respite, with and without RN delegation, including SRO; and

(ii) flexible family support, with and without RN delegation, including SRO;

(11) in the STAR+PLUS Program:
(A) personal assistance services, including SRO;

(B) CFC PAS, including SRO; and

(C) CFC HAB, including SRO;

(12) in the STAR+PLUS HCBS Program:
(A) in-home respite care, including SRO;

(B) protective supervision, including SRO;

(C) personal assistance services, including SRO;

(D) CFC PAS, including SRO; and

(E) CFC HAB, including SRO;

(13) in the STAR+PLUS MMP:
(A) in-home respite care, including SRO;

(B) protective supervision, including SRO;

(C) personal assistance services, including SRO;

(D) CFC PAS, including SRO; and

(E) CFC HAB, including SRO;

(14) in the TxHmL Program:
(A) CFC PAS/HAB;

(B) in-home respite; and

(C) in-home individualized skills and socialization;

(15) in-home respite provided in the YES Program; and

(16) any other service required by federal or state mandates.

(b) A CDS employer must ensure a service provider uses EVV to document the provision of the following personal care services through the CDS option:

(1) in the traditional Medicaid service model also referred to as fee-for-service:
(A) CFC PAS;

(B) CFC HAB;

(C) PCS provided under Texas Health Steps CCP; and

(D) PCS-Behavioral Health provided under Texas Health Steps CCP;

(2) in the CLASS Program:
(A) CFC PAS/HAB; and

(B) in-home respite;

(3) personal attendant services provided through the Community Attendant Services Program;

(4) in the DBMD Program:
(A) CFC PAS/HAB; and

(B) in-home respite;

(5) personal attendant services provided through the FC Program;

(6) in the HCS Program:
(A) CFC PAS/HAB; and

(B) in-home respite;

(7) personal attendant services provided through the Primary Home Care Program;

(8) in the STAR Health Program:
(A) CFC PAS;

(B) CFC HAB; and

(C) for a member in STAR Health MDCP:
(i) in-home respite, with and without RN delegation; and

(ii) flexible family support, with and without RN delegation;

(9) in the STAR Kids Program:
(A) CFC PAS;

(B) CFC HAB; and

(C) for a member in STAR Kids MDCP:
(i) in-home respite, with and without RN delegation; and

(ii) flexible family support, with and without RN delegation;

(10) in the STAR+PLUS Program:
(A) personal assistance services;

(B) CFC PAS; and

(C) CFC HAB;

(11) in the STAR+PLUS HCBS Program:
(A) in-home respite care;

(B) protective supervision;

(C) personal assistance services;

(D) CFC PAS; and

(E) CFC HAB;

(12) in the STAR+PLUS MMP:
(A) in-home respite care;

(B) protective supervision;

(C) personal assistance services;

(D) CFC PAS; and

(E) CFC HAB; and

(13) in the TxHmL Program:
(A) CFC PAS/HAB;

(B) in-home respite; and

(C) in-home individualized skills and socialization.

Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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