Rate Packets

NOTE: The HHSC Rate Analysis Department has moved locations. See our new mailing address below.

File Extension Key
(.pdf) - Adobe, (.xls) - Excel, (.zip) - Winzip

Proposed to be Effective

Upon the Effective Date of the Facility's Medicaid Nursing Facility Contract

• Proposed Payment Rates for Medicaid Hospice (.pdf) Hospice Attachment (.pdf)
• Tyler State Owned Veterans Home (.pdf)

July 1, 2013

• Calendar Fee Review (.pdf) CFR Attachment (.zip) (updated 07/22/13)
• Certified Respiratory Care Practitioner (.pdf) CRCP Attachment (.pdf)
• Dental Services (.pdf) Dental Services Attachment (.pdf)
• Diabetic Equipment and Supplies (.pdf) Diabetic Equipment and Supplies Attachment (.pdf)
• Durable Medical Equipment, Prosthetics, Orthotics and Supplies (.pdf); DMEPOS Attachments (.pdf)
• HPCPCS Updates (.pdf) HPCPCS Attachment (.pdf)
• Incontinence Supplies (.pdf) Incontinence Supplies Attachment (.pdf) (updated 07/22/13)
• Mobility Aids (.pdf) Mobility Aids Attachment (.pdf) (updated 07/22/13)
• Orthoses CCP (.pdf) Orthoses CCP Attachment (.pdf)
• Physician Administered Drugs (.pdf) Physician Administered Drugs Attachment (.pdf) (updated 07/22/13)

June 1, 2013

• Anesthesiologist Assistants (.pdf) Anesthesiologist Assistants Attachment (.pdf) (updated 07/22/13)
• Hearing Devices (.pdf) Hearing Devices Attachment (.pdf)

May 1, 2013

• Preadmission Screening & Resident Review (.pdf)

April 1, 2013

• Aerosol Treatments (.pdf) Aerosol Treatments Attachment (.pdf)
• Calendar Fee Review (.pdf) CFR Attachments (.zip)
• Evoked Response Tests (.pdf) ERT Attachments (.pdf)
• HCPCS Updates - 3rd Quarter 2012 (.pdf)
• Telemedicine and Telehealth (.pdf) Telemedicine and Telehealth Attachment (.pdf)
• THSteps Therapeutic Dental (.pdf) THSteps Attachment (.pdf)
• Vaccines and Toxiods (.pdf)
• Youth Empowerment Services Waiver Program (.pdf)

January 1, 2013

• Ambulance Services (.pdf) Ambulance Services Attachment (.pdf)
• Calendar Fee Review (.pdf) CFR Attachment 1 (.pdf) CFR Attachment 2 (.pdf)
• Case Management for Children and Pregnant Women (.pdf)
• Dental Services (.pdf)
• HCPCS 2013 Annual Update (.pdf) HCPCS Attachment (.zip)
• Hearing Aids (.pdf)
• Licensed Midwife Services in a Birthing Center Rates (.pdf) LMW Attachment (.pdf)
• Psychiatric Services (.pdf) Psychiatric Services Attachment (.pdf)
• Primary Care Services and Vaccine Administration Services (.pdf) PCS Attachment (.pdf) VA Attachment (.pdf)
• Residential Care, CBA Assisted Living/Residential Care, and Personal Care 3 (.pdf) RC Attachment 1 (.pdf) RC Attachment 2 (.pdf) RC Attachment 3 (.pdf) (Updated 11/27/12)
• Vaccine & Toxoids (Shingles Vaccine) (.pdf) Vaccine Attachment (.pdf)

October 1, 2012

• Calendar Fee Review (.pdf) CFR Attachment (.zip) - updated 08/16/12
• Computed Tomography and Magnetic Resonance Imaging (.pdf) CT MRI Attachment (.pdf)
• HCPCS Updates (.pdf) HCPCS Attachment (.pdf)
• Hearing Devices (.pdf) Hearing Devices Attachment (.pdf)

September 1, 2012

• CLASS Supported Employment and DBMD Employment Assistance and Supported Employment Proposed Rates (.pdf); CLASS Attachment (.pdf); DBMD Attachment (.pdf)
• Payment Rates for Small and Large, State-Operated Intermediate Care Facilities for
  Individuals who are Intellectually Disabled (ICF/IID) (.pdf)
  
• Proposed Payment Rates for CBA, MDCP, and DAHS (.pdf); Payment Rates Attachment
• Reimbursement Methodology for Inpatient Hospitals (.pdf) Inpatient Hospital Attachment (.xls) Proposed Rules (.pdf)
• Truman Smith (.pdf) - updated 07/17/2012

August 1, 2012

• Proposed Payment Rates for 24-RCC Foster Care Redesign (.pdf); 24-RCC Attachment (.pdf)

July 1, 2012

• Proposed Payment Rates for 24-RCC Foster Care Redesign (.pdf); 24-RCC Attachment (.pdf)
• Calendar Fee Review (.pdf); CFR Attachments (.zip) (updated 05/18/12)
• Doctor of Dentistry Services (.pdf)
• HCPCS 2011 3rd Quarter (.pdf)
• Immune Globulins (.pdf)
• Special Review - E Codes (.pdf)

June 1, 2012

• Blind Children's Vocational Discovery and Development Program (.pdf)

April 1, 2012

• Calendar Fee Review (.pdf) (updated 02/09/12); CFR Attachments (.zip) (updated 02/14/12)
• Youth Empowerment Services Waiver Program (.pdf)

March 1, 2012

• Durable Medical Equipment, Prosthetics, Orthotics and Supplies (.pdf); DMEPOS Attachments (.zip) (updated 02/10/12)
• State Veterans Homes (.pdf)
• Therapy Services provided by CORF/ORF, Home Health Agencies, and Independent Practitioners (.pdf) (updated 01/13/12); CORF/ORF, HHA, and Independent Practitioners Attachments (.zip) (updated 01/13/12)

January 1, 2012

• Calendar Fee Review (.pdf); CFR Attachments (.zip) (updated 01/06/12)
• Diabetic Equipment and Supplies (.pdf); DES Attachment (.xls)
• HCPCS 2011 2nd - 3rd Quarter (.pdf) (updated 11/04/11)
• HCPCS 2012 (.pdf); HCPCS 2012 Attachments (.zip) (updated 02/10/12)
• Incontinence A6250 (.pdf); Incontinence A6250 Attachment (.xls)
• Indian Health Services (.pdf)
• Radiology Diagnostic Imaging (.pdf); RDI Attachment (.xls) (updated 11/04/11)
• Renal Dialysis (.pdf)
• Residential Care, Community Based Alternatives Assisted Living/Residential Care and Personal Care 3 (.pdf)
• Tobacco Cessation Counseling (.pdf); Tobacco Cessastion Counseling Attachment (.xls)
• Wound Care Management (.pdf); Wound Care Management Attachment (.xls)

December 1, 2011

• Supervised Independent Living (SIL) Program (.pdf) (updated 08/25/11) SIL Attachment (.xls) (updated 08/22/11)

October 1, 2011

• Calendar Fee Review (.pdf) CFR Attachments (.zip)
• Healthcare Common Procedure Coding System Updates (.pdf)
• Hospice (.pdf)
• Proposed Elimination of Certain Procedure Codes as Medicaid Benefits (.pdf) Procedure Code Attachment (.xls)
• Specialized Skills Training and Targeted Case Management for the Early Childhood Intervention Program (.pdf)
• Vagal Nerve Stimulator and Lead (.pdf)

September 1, 2011

• Community Based Alternatives Waiver Program (.pdf) (updated 08/04/11)
• Revised Durable Medical Equipment, Prosthetics, Orthotics and Supplies (.pdf) DMEPOS Attachment (.xls) (updated 07/06/11) Supplemental DMEPOS Attachment (.xls) (updated 07/20/11)
• Home and Community-based Services and Texas Home Living Waiver Programs and Associated Services (.pdf) HCS Attachment (.xls)
• Hospice - Nursing Facility and Hospice - Intermediate Care Facility for Persons with Mental Retardation (.pdf)
• Hospital and Clinic Services (.pdf); Hospital Attachment (.xls) (updated 08/04/11)
• Mental Retardation Service Coordination (.pdf)
• Non-State Operated Intermediate Care Facilities for Persons with Mental Retardation and Associated Services (.pdf); ICF-MR Attachment (.xls)
• Proposed Medicaid Payments Implementing Legislative Directives (.pdf)
• Reimbursement Methodology for Inpatient Hospitals (.pdf); Proposed Inpatient Hospitals Rule 355-8052 (.pdf); Inpatient Hospitals Attachment (.xls) (updated 07/26/11)
• State Operated Intermediate Care Facilities for Persons with Mental Retardation (.pdf)
• Targeted Case Management and Rehabilitative Services (.pdf)
• Truman W. Smith Children's Care Center (.pdf)

July 1, 2011

• Calendar Fee Review (.pdf); CFR Attachments (.zip)
• Diabetic Equipment and Supplies (.pdf); DES Attachment (.pdf) (updated 05/05/11)
• Incontinence Supplies Home Health (.pdf); ISHH Attachment (.pdf)
• Mobility Aids (.pdf); MA Attachment (.pdf)
• Otology and Audiometry Services (.pdf); OAS Attachment (.pdf)
• S96110 (.pdf); S96110 Attachment (.pdf)
• Surgical Procedures (.pdf); SP Attachment (.pdf)
• Vitamins and Minerals (.pdf); V&M Attachment (.pdf)

June 1, 2011

• 17-Alpha Hydroxyprogesterone Caproate (.pdf); AHC Attachment (.pdf) (updated 05/10/11)
• Blind Children's Vocational Discovery and Development Program (.pdf)
• Substance Use Disorder Services (.pdf); SUDS Attachment (.pdf) (updated 05/19/11)

April 1, 2011

• Biofeedback Services (.pdf)
• Calendar Fee Review (.pdf); CFR Attachments (.zip)
• Certified Respiratory Care Practitioner Services (.pdf)
• Esophageal PH Probe Monitoring (.pdf); EPM Attachment (.pdf)
• Implantable Infusion Pump (.pdf)
• Incontinence Supplies - Home Health Policy (.pdf); IS Attachment (.pdf)
• Physician Evaluation and Management Services (.pdf)
• Vaccine Administration (.pdf); VA Attachment (.pdf)

March 1, 2011

• State Veterans Homes (.pdf)
• Substance Use Disorder - Medication Assisted Therapy for Methadone (.pdf)

February 1, 2011

• Ambulance Services; Case Management for Pregnant Women; Early and Periodic Screening, Diagnosis and Treatment Services, including Medical Checkups, Private Duty Nursing, and Therapies in a Comprehensive Outpatient Rehabilitation Facility / Outpatient Rehabilitation Facility, but not including Personal Care Services; Family Planning Services; Home Health Services, including Professional Services and Durable Medical Equipment and Expendable Supplies; Mental Health Rehabilitation Services; Mental Health Targeted Case Management; Physicians and Certain Other Practitioners, including Dental Services, Anesthesia Services, Licensed Clinical Social Workers, Licensed Professional Counselors, Licensed Marriage and Family Therapists, and other practitioners; Tuberculosis Clinics; and the Vendor Drug Dispensing Fee (.pdf)
• Calendar Fee Reviews (.pdf); CFR Attachment (.pdf)
• Home and Community-Based Services and Texas Home Living (.pdf); HBS Attachment (.pdf); Revised December 29, 2010 - HCS Rate Packet Attachment
• Hospital Reimbursement 2% Reduction (.pdf)
• Non-State Operated Intemediate Care Facilities for Persons with Mental Retardation (.pdf); ICF Attachment (.pdf)
• Nursing Facility and Hospice-Nursing Facility Payment Rates (.pdf); NF Attachment (.pdf)

January 1, 2011

• Family Planning Providers (.pdf)
• FREW Policy Review (.pdf); Frew Attachments (.zip)
• Healthcare Common Procedure Coding System Updates for 2nd Quarter (.pdf)
• Healthcare Common Procedure Coding System 2011 Annual Updates (.pdf); HCPCS Attachments (.zip)
• Indian Health Services (.pdf)
• Substance Use Disorder (.pdf); SUD Attachment (.pdf)

October 1, 2010

• Calendar Fee Reviews(.pdf); CFR Attachments(.zip)
• Family Planning Providers(.pdf); FPS Attachment (.pdf)
• Healthcare Common Procedure Coding System Updates for 1st and 2nd Quarter (.pdf)
• Nutritional (Enteral) Products, Supplies, Equipment - Comprehensive Care Program(.pdf)
• Nutritional (Enteral) Products, Supplies, Equipment - Home Health(.pdf)
• Total Parenteral Nutrition(.pdf)

September 1, 2010

• Ambulance Providers/Licensed Clinical Social Workers/Licensed (.pdf)
• Ambulatory Surgical Centers (.pdf)
• Birthing Center Services(.pdf)
• Blood Factor Products Furnishing Fee(.pdf)
• Case Management for Children and Pregnant Women (.pdf)
• Disproportional Share Hospital (DSH) Reimbursement Methodology (.pdf)
• EPSDT Providers/CORF/ORF(.pdf)
• EPSDT Providers/EPSDT PCS/EPSDT PDN (.pdf)
• Freestanding Psychiatric Facilities (.pdf)
• Home Health Services and Family Planning Providers(.pdf)
• Hospital Outpatient Services (.pdf)
• MH Targeted Case Management MHMR(.pdf)
• Non-State ICF for Persons with Mental Retardation(.pdf); ICF Attachment(.xls)
• Nursing Facilities (.pdf); NF Attachment(.xls)
• Pharmacy Dispensing Fee (.pdf)
• Physicians and Certain Other Practitioners(.pdf)
• Professional Counselors/Licensed Marriage and Family Therapists(.pdf)
• Renal Dialysis Facilities/Non-State Clinical Lab Services(.pdf)
• Small and Large, State-Operated Intermediate Care Facilities for Persons with Mental Retardation (ICF/MR)(.pdf)
• Substance Use Disorder(.pdf); SUD Attachment(.xls)
• Truman W. Smith Children's Care Center(.pdf)

 

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Regular Mail:	Overnight and Courier Delivery:
HHSC Rate Analysis	HHSC Rate Analysis
Mail Code H-400	Mail Code H-400
P.O. Box 149030	4900 North Lamar
Austin, Texas 78714	Austin, Texas 78751

 

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Updated: May 22, 2013