Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 363 - TEXAS HEALTH STEPS COMPREHENSIVE CARE PROGRAM
Subchapter B - PRESCRIBED PEDIATRIC EXTENDED CARE CENTER SERVICES
Section 363.213 - Ordering Physician Responsibilities
Universal Citation: 1 TX Admin Code ยง 363.213
Current through Reg. 49, No. 38; September 20, 2024
(a) An ordering physician in an employment or contractual relationship with a PPECC cannot provide the required physician's order unless the physician has a therapeutic relationship with and ongoing clinical knowledge of the participant.
(b) The ordering physician's responsibilities include:
(1) providing an examination or
treatment to the participant within 30 days before the start of PPECC
services;
(2) providing a signed
prescription or written, dated physician's order for PPECC services within 30
calendar days before the participant's start of services, which is valid
through the initial authorization period and complies with requirements
contained in the Texas Medicaid Provider Procedures Manual;
(3) providing a signed prescription or
written, dated physician's order for each PPECC authorization period, once the
initial prescription or order is no longer valid;
(4) performing a face-to-face evaluation of
the participant each year;
(5)
reviewing, approving, signing, and dating a plan of care, and any other
documentation required for service prior authorization, including any updates
or changes;
(6) affirming in
writing that PPECC services are medically necessary for the
participant;
(7) affirming in
writing that the participant's medical condition is sufficiently stable to
permit safe delivery of PPECC services as described in the plan of care;
and
(8) providing continuing care
to and medical supervision of the participant.
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