The State Plan - Medicaid

The State Plan is the officially recognized document describing the nature and scope of the State of Texas Medicaid program. As required under Section 1902 of the Social Security Act, the plan was developed by our state and approved by the U.S. Department of Health and Human Services. Essentially, the plan is our state's agreement that it will conform to the requirements of the Social Security Act and the official issuances of the U.S. Department of Health and Human Services.

Plan changes are submitted by the state to the U.S. Department of Health and Human Services (HHS) as State Plan Amendments (SPAs). Through the Centers for Medicare and Medicaid Services (CMS), HHS reviews each SPA to determine whether it meets federal requirements and policies.The plan is updated when CMS issues final approval of a SPA.

The plan on this website is for informational purposes only and is not legally binding. The official plan is maintained by CMS Region 6.

Once the plan file is opened, you can access specific sections of the plan in one of two ways.

1. Click on the Bookmark tab to the left of the plan pages to see a detailed index.
2. Use the search function to find information within the plan by key words or phrases. Please remember that since the documents are PDF, the search function is not 100 percent accurate in all circumstances.

Approved State Plan Amendments will be posted as updates are made to the plan. An updated plan will be posted at the beginning of each calendar year.

This plan is current as of January 19, 2012

• Basic State Plan – Medicaid(PDF)
• State Plan Attachments (PDF)
• Download the State Plan in its entirety (pdf)

State Plan Amendments

January 2012

• 11-027 Dispensing Fee
• 11-051 Public Assistance Reporting Information System (PARIS)
• 11-052 1915(j) Update

• 11-031 Outpatient
• 11-060 Upper Payment Limit (UPL) Removal

March 2012

• 11-029 Birthing Centers
• 11-045 Medicare Equalization
• 11-047 Tuberculosis Clinics
• 11-056 Early Childhood Intervention (ECI) Targeted Case Management
• 11-059 Physicians
• 12-004 Early and Periodic Screening, Diagnosis and Treatment (EPSDT) and Audiology