Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 211 - DAY ACTIVITY AND HEALTH SERVICES (DAHS) CONTRACTUAL REQUIREMENTS
Section 211.211 - Billing and Payment
Universal Citation: 26 TX Admin Code ยง 211.211
Current through Reg. 49, No. 38; September 20, 2024
(a) The method of payment is a unit of authorized service and is defined as half a day. One unit of service constitutes three hours but less than six hours of covered services provided by the DAHS facility. Six hours or more of service constitutes two units of service. Time spent in approved transportation provided by the DAHS facility shall be counted in the unit of service.
(b) The DAHS facility is not entitled to payment if:
(1) the DAHS facility fails to
submit prior approval forms or supporting documentation to the regional nurse
within the required time frames for DAHS facility initiated
referrals;
(2) the DAHS facility
did not maintain the staff-client ratio for one or more days;
(3) the DAHS facility exceeded its license
capacity; or
(4) the DAHS
facility's monthly claims do not correspond to the DAHS facility's service
authorizations and DADS' Daily Attendance/Daily Transportation Record
form.
Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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