Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION
Subchapter BB - NURSING FACILITY RESPONSIBILITIES RELATED TO PREADMISSION SCREENING AND RESIDENT REVIEW (PASRR)
Division 3 - NURSING FACILITY SPECIALIZED SERVICES FOR DESIGNATED RESIDENTS
Section 554.2753 - Payment for Therapy Services
Current through Reg. 49, No. 38; September 20, 2024
(a) HHSC pays a nursing facility for therapy services provided to a designated resident based on fees determined in accordance with 1 TAC § 355.313(relating to Reimbursement Methodology for Rehabilitative and Specialized Services).
(b) A therapy session is one hour of therapy provided to one resident.
(c) An assessment is reimbursed at the same rate as a therapy session.
(d) An occupational therapist or physical therapist may assess a designated resident at any time to evaluate the needs of the designated resident for a therapy service, but HHSC does not pay for an assessment of a designated resident conducted within 180 days after the previous assessment of the designated resident.
(e) A nursing facility must submit a complete and accurate claim for a therapy service within 12 months after the last day of an authorization from HHSC to provide the service.
