Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 355 - REIMBURSEMENT RATES
Subchapter J - PURCHASED HEALTH SERVICES
Division 13 - CHEMICAL DEPENDENCY TREATMENT FACILITY SERVICES
Section 355.8241 - Reimbursement Methodology for Chemical Dependency Treatment Facilities
Current through Reg. 49, No. 38; September 20, 2024
(a) Subject to the specifications, conditions, limitations, and requirements established by the Health and Human Services Commission (HHSC), payment for covered chemical dependency treatment facility services provided by a participating chemical dependency treatment facility (CDTF) is limited to the lesser of the provider's customary charge or the maximum allowable fee established by HHSC.
(b) A CDTF must bill for the covered services that it provides. Services provided by an attending physician or laboratory will be reimbursed separately. The CDTF must be enrolled and approved for participation in the Medicaid program at the time the services are provided.
(c) HHSC will conduct periodic rate reviews and will update the Medicaid CDTF fee schedule as needed. HHSC may adjust rates based on an analysis of:
