26 Tex. Admin. Code § 554.2753

Current through Reg. 49, No. 49; December 6, 2024
Section 554.2753 - Payment for Therapy Services
(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.

26 Tex. Admin. Code § 554.2753

Adopted by Texas Register, Volume 42, Number 35, September 1, 2017, TexReg 4479, eff. 9/10/2017; Entire chapter transferred from Title 40, Pt. 1, Ch. 19 by Texas Register, Volume 45, Number 50, December 11, 2020, TexReg 8871, eff. 1/15/2021