Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 355 - REIMBURSEMENT RATES
Subchapter J - PURCHASED HEALTH SERVICES
Division 2 - MEDICAID HOME HEALTH PROGRAM
Section 355.8021 - Reimbursement Methodology for Home Health Services

(a) Authorized home health nursing and aide services provided to eligible Medicaid recipients are reimbursed the lesser of the billed amount or the Medicaid reimbursement rate established by HHSC.

(b) HHSC reviews the fees for nursing and aide services at least once every two years based upon:

(c) HHSC may use data sources or methodologies other than those listed in subsection (b) of this section to establish Medicaid fees for home health services when HHSC determines that the methodologies in subsection (b) of this section are unreasonable or insufficient.

(d) Reimbursement for Physical, Occupational, and Speech Therapy Services is described in § 355.8097 of this title (relating to Reimbursement for Physical, Occupational, and Speech Therapy Services).

(e) Fees for home health services will be adjusted within available funding as described in § RSA 355.201 of this title (relating to Establishment and Adjustment of Reimbursement Rates by the Health and Human Services Commission).