1. (a) A program provider must ensure a service provider uses EVV to document the provision of the following home health care services by the program provider on or after January 1, 2024:

   1. (1) in the traditional Medicaid service model also referred to as fee-for-service, for a member who does not reside in a nursing facility, an ICF/IID, or an IMD, the following services when provided in the residence of the member:

      1. (A) any nursing service, other than PDN;
      2. (B) occupational therapy; and
      3. (C) physical therapy;

   2. (2) in the CLASS Program, for a member who does not receive support family services or continued family services, the following services when provided in the residence of the member:

      1. (A) any nursing service;
      2. (B) occupational therapy; and
      3. (C) physical therapy;

   3. (3) in the DBMD Program, for a member who does not receive licensed assisted living or licensed home health assisted living, the following services when provided in the residence of the member:

      1. (A) any nursing service;
      2. (B) occupational therapy; and
      3. (C) physical therapy;

   4. (4) in the HCS Program, for a member whose residential type is "own/family home," the following services when provided in the residence of the member:

      1. (A) any nursing service;
      2. (B) occupational therapy; and
      3. (C) physical therapy;

   5. (5) in the HCBS-AMH Program, for a member who does not receive host home/companion care, supervised living services, or assisted living services, the following services when provided in the residence of the member:

      1. (A) nursing - RN; and
      2. (B) nursing - LVN;

   6. (6) in the STAR Program, the following services when provided in the residence of the member:

      1. (A) home health nursing;
      2. (B) occupational therapy;
      3. (C) physical therapy; and
      4. (D) personal care services provided by a home health aide under the supervision of an RN, occupational therapist, or physical therapist;

   7. (7) in the STAR Health Program, the following services when provided in the residence of the member:

      1. (A) home health nursing, other than PDN;
      2. (B) occupational therapy;
      3. (C) physical therapy; and
      4. (D) personal care services provided by a home health aide under the supervision of an RN, occupational therapist, or physical therapist;
      5. (E) nursing delegation and supervision of PCS and CFC tasks; and

      6. (F) for a member in STAR Health MDCP, the following services when provided in the residence of the member:

         1. (i) RN delegation and supervision of personal care services and CFC tasks, other than PDN;
         2. (ii) flexible family supports services performed by RN or an LVN; and
         3. (iii) in-home respite performed by RN or an LVN;

   8. (8) in the STAR Kids Program, the following services when provided in the residence of the member:

      1. (A) home health nursing, other than PDN;
      2. (B) occupational therapy;
      3. (C) physical therapy;
      4. (D) personal care services provided by a home health aide under the supervision of an RN, occupational therapist, or physical therapist;
      5. (E) nursing delegation and supervision of PCS and CFC tasks; and

      6. (F) for a member in STAR Kids MDCP, the following services when provided in the residence of the member:

         1. (i) RN delegation and supervision of personal care services and CFC tasks, other than PDN;
         2. (ii) flexible family supports services performed by an RN or LVN; and
         3. (iii) in-home respite performed by an RN or LVN;

   9. (9) in the STAR+PLUS Program, the following services when provided in the residence of the member:

      1. (A) home health nursing;
      2. (B) occupational therapy;
      3. (C) physical therapy; and
      4. (D) personal care services provided by a home health aide under the supervision of an RN, occupational therapist, or physical therapist;

   10. (10) in the STAR+PLUS HCBS Program, for members not receiving adult foster care, assisted living services - single occupancy, assisted living services - double occupancy, or assisted living services - non-apartment, the following services when provided in the residence of the member:

       1. (A) home health nursing, including SRO;
       2. (B) occupational therapy, including SRO;
       3. (C) physical therapy, including SRO; and
       4. (D) personal care services provided by a home health aide under the supervision of an RN, occupational therapist, or physical therapist, including SRO;

   11. (11) in the STAR+PLUS MMP, for members not receiving adult foster care, assisted living services - single occupancy, assisted living services - double occupancy, or assisted living services - non-apartment, the following services when provided in the residence of the member:

       1. (A) home health nursing, including SRO;
       2. (B) occupational therapy, including SRO;
       3. (C) physical therapy, including SRO; and
       4. (D) personal care services provided by a home health aide under the supervision of an RN, occupational therapist, or physical therapist, including SRO;

   12. (12) in the TxHmL Program, the following services when provided in the residence of the member:

       1. (A) any nursing service;
       2. (B) occupational therapy; and
       3. (C) physical therapy; and
   13. (13) any other service required by federal or state mandates.

2. (b) A CDS employer must ensure a service provider uses EVV to document the provision of the following home health care services using the CDS option on or after January 1, 2024:

   1. (1) in the CLASS Program, the following services when provided in the residence of the member:

      1. (A) any nursing service;
      2. (B) occupational therapy; and
      3. (C) physical therapy;

   2. (2) in the HCS Program, for a member whose residential type is "own/family home," the following services when provided in the residence of the member:

      1. (A) any nursing service;
      2. (B) occupational therapy; and
      3. (C) physical therapy;

   3. (3) in the STAR Health Program for a member in STAR Health MDCP, the following services when provided in the residence of the member:

      1. (A) flexible family supports services performed by any RN or any LVN; and
      2. (B) in-home respite performed by any RN or any LVN;

   4. (4) in the STAR Kids Program for a member in STAR Kids MDCP, the following services when provided in the residence of the member:

      1. (A) flexible family supports services performed by any RN or any LVN; and
      2. (B) in-home respite performed by any RN or any LVN;

   5. (5) in the STAR+PLUS Program, the following services when provided in the residence of the member:

      1. (A) home health nursing;
      2. (B) occupational therapy;
      3. (C) physical therapy; and
      4. (D) personal care services provided by a home health aide under the supervision of an RN, occupational therapist, or physical therapist;

   6. (6) in the STAR+PLUS HCBS Program, the following services when provided in the residence of the member:

      1. (A) home health nursing;
      2. (B) occupational therapy;
      3. (C) physical therapy; and
      4. (D) home health aide services as an extension of physical therapy, occupational therapy, or nursing services;

   7. (7) in the STAR+PLUS MMP, the following services when provided in the residence of the member:

      1. (A) home health nursing;
      2. (B) occupational therapy;
      3. (C) physical therapy; and
      4. (D) home health aide services as an extension of physical therapy, occupational therapy, or nursing services; and

   8. (8) in the TxHmL Program, the following services when provided in the residence of the member:

      1. (A) any nursing service;
      2. (B) occupational therapy; and
      3. (C) physical therapy.

Source Note:The provisions of this §354.4006 adopted to be effective January 1, 2024, 48 TexReg 7171.