Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
Subchapter F - SERVICE DESCRIPTIONS AND REQUIREMENTS
Division 4 - NON-BILLABLE TIME AND ACTIVITIES
Section 260.357 - Non-Billable Time and Activities
Current through Reg. 49, No. 38; September 20, 2024
A program provider must not bill for and HHSC does not reimburse for:
(1) services provided to an individual before HHSC's approval of the individual's request for enrollment in the DBMD Program;
(2) supervision of service providers unless providing delegated tasks;
(3) phone calls, text messages, emails, letters, or meetings with HHSC or community resources that do not directly address an individual's services;
(4) administrative meetings or staff meetings;
(5) in-service training, general training, continuing education, or conferences;
(6) employee conferences or evaluations;
(7) filing claims for services;
(8) traveling to and from an individual's residence, except when a day habilitation, transportation provided as a residential habilitation activity, or in-home respite service provider is transporting the individual;
(9) processing paperwork or completing records or reports;
(10) services not included on an approved IPC;
(11) services that are mutually exclusive;
(12) other services and activities not authorized, permitted, or allowed under this chapter;
(13) routine care and supervision that a family member is legally obligated to provide;
(14) activities or supervision for which a payment is made by a source other than Medicaid;
(15) room and board;
(16) any expense related to providing transportation provided as a residential habilitation activity, nursing, out-of-home respite in a camp, case management, adaptive aids, intervener services, or CFC PAS/HAB outside the program provider's contracted service delivery area, including costs for transportation or lodging;
(17) transportation provided as a residential habilitation activity, nursing, out-of-home respite in a camp, case management, adaptive aids, intervener services, or CFC PAS/HAB provided to an individual outside the program provider's contracted service delivery area if the individual has received services outside the program provider's contracted service delivery during a period of more than 60 consecutive days;
(18) two or more services provided at the same time by the same service provider; or
(19) an item or service provided to an individual at the request of the individual or LAR that is not a reimbursable item in the DBMD Program.