Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 355 - REIMBURSEMENT RATES
Subchapter D - REIMBURSEMENT METHODOLOGY FOR INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS (ICF/IID)
Section 355.455 - Payments to Non-State Operated Facilities
Current through Reg. 49, No. 38; September 20, 2024
(a) HHSC or its designee will pay to non-state-operated facilities modeled rates that will vary by class of facility and a resident's level-of-need.
(b) The non-state operated facility modeled rates include payment for both residential and day program services. Residents receive medical and dental services through the Medicaid identification card. Any medical expenses other than Medicaid-covered services are the responsibility of the ICF/MR provider.
(c) With a limit of $5,000 per resident per year, HHSC or its designee will pay a provider for the actual cost of a resident's durable medical equipment, excluding augmentative communication devices, if:
(d) Reimbursement for augmentative communication devices is governed by 40 TAC §RSA 9.228, relating to Augmentative Communication Device Systems.
