Section 260.357 - Non-Billable Time and ActivitiesA 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;(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.26 Tex. Admin. Code § 260.357
Adopted by Texas Register, Volume 48, Number 07, February 17, 2023, TexReg 0918, eff. 2/26/2023