Nurse Practitioner and Clinical Nurse Specialist
Overview
An advanced practice registered nurse (APRN) is licensed by the Texas Board of Nursing or another state's licensing authority as recognized by the Texas Board of Nursing
Contacts
Note: Rate Analysis staff can assist you with questions concerning only payment rates for the specified services. They are not able to answer other types of questions, such as the status of payment for services rendered or questions involving eligibility for care services. Please refer to the Section entitled "Nurse Practitioner (NP) and Clinical Nurse Specialist (CNS)" in the current Texas Medicaid Provider Procedures Manual (TMPPM).
If you have questions regarding Nurse Practitioner (NP) and Clinical Nurse Specialist (CNS) payment rates, please call the Rate Analyst on the Contacts List.
If you have questions regarding Nurse Practitioner and Clinical Nurse Specialist program/policy issues, please call the TMHP Contact Center on the Contacts List.
Methodology / Rules
The Nurse Practitioner (NP) and Clinical Nurse Specialist (CNS) program rules are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 354, SubChapter A, Division 24, Rules 1331-1332.
Reimbursement rules applicable to the Medicaid services delivered by Nurse Practitioner (NP) and Clinical Nurse Specialist (CNS) services are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 355, SubChapter J, Division 15, Rule 8281 and Division 5, Rule 8085.
The fee schedules and any periodic adjustment(s) to the fee schedules are published in banner messages contained in provider Remittance and Status (R&S) reports, Medicaid Bulletin articles, web postings, provider manual, fee schedules or other provider notification.
Payment Rate Information
Payment rate information is published by procedure code in the applicable Texas Medicaid Fee Schedule located on the Texas Medicaid & Healthcare Partnership (TMHP) website (see Fee Schedules).
Contact Rate Analysis
Updated: May 13, 2013