Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 355 - REIMBURSEMENT RATES
Subchapter M - MISCELLANEOUS PROGRAMS
Division 7 - COMMUNITY FIRST CHOICE
Section 355.9090 - Reimbursement Methodology for Community First Choice

(1) CFC State Plan Rate--Attendant and Habilitation: Rates will be equal to a weighted average of rates established for Community Living Assistance and Support Services (CLASS) habilitation services according to the reimbursement methodology for the CLASS program under § RSA 355.505 of this title (relating to Reimbursement Methodology for the Community Living Assistance and Support Services Waiver Program) and proxy rates for attendant services used in the calculation of the STAR+PLUS managed care capitation rates for the Home and Community-based Services (HCBS) risk group. The weighted average will include applicable attendant compensation rate enhancements.

(2) CLASS--Attendant and Habilitation CFC: Rates will be equal to rates established for CLASS habilitation services, including applicable attendant compensation rate enhancements, under § RSA 355.505 of this title.

(3) Deaf-Blind with Multiple Disabilities (DBMD)--Attendant and Habilitation CFC: Rates will be equal to rates established for DBMD Residential Habilitation, including applicable attendant compensation rate enhancements, under § RSA 355.513 of this title (relating to Reimbursement Methodology for the Deaf-Blind with Multiple Disabilities Waiver Program).

(4) Home and Community-Based Services (HCS)--Supported Home Living (SHL) CFC: Rates will be equal to rates established for HCS SHL, including applicable attendant compensation rate enhancements, under § RSA 355.723 of this title (relating to Reimbursement Methodology for Home and Community-Based Services and Texas Home Living Programs).

(5) Texas Home Living (TxHmL)--Community Support Services (CSS) CFC: Rates will be equal to rates established for TxHmL CSS, including applicable attendant compensation rate enhancements, under § RSA 355.723 of this title.

(6) Personal Care Services (PCS)--Habilitation CFC: Rates will be equal to rates established for PCS attendant services for recipients with a behavioral health condition under § RSA 355.8441 of this title (relating to Reimbursement Methodologies for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Services).

(7) Personal Care Services (PCS)--Attendant CFC: Rates will be equal to the rates established for PCS attendant services for recipients without a behavioral health condition under § RSA 355.8441 of this title.

(8) Consumer Directed Services (CDS)--CFC: Rates will be equal to rates established for CDS for the equivalent non-CFC service under § RSA 355.114 of this title (relating to Consumer Directed Services Payment Option).

(9) Support Consultation Services--CFC: Rates will be equal to rates established for Support Consultation Services under § RSA 355.114 of this title.

(10) CFC State Plan rate for Financial Management Services Agencies (FMSA) (only authorized for individuals receiving all of their CDS services under CFC): Rates will be equal to rates established for FMSAs for an equivalent non-CFC service under § RSA 355.114 of this title.

(11) Emergency Response Services (ERS)--CFC: Rates will be equal to rates established for ERS under § RSA 355.510 of this title (relating to Reimbursement Methodology for Emergency Response Services (ERS)).