26 Tex. Admin. Code § 277.89
Reimbursement
Effective Oct 1, 201944 TexReg 5138Source Note: The provisions of this §277.89 adopted to be effective June 1, 2004, 29 TexReg 5113; amended to be effective June 1, 2009, 34 TexReg 2802; amended to be effective October 1, 2013, 38 TexReg 6621; amended to be effective September 1, 2014, 39 TexReg 6635; amended to be effective October 1, 2019, 44 TexReg 5138; transferred effective July 1, 2024, as published in the June 14, 2024, issue of the Texas Register, 49 TexReg 4436.Texas Secretary of State
(a) Billing requirements. A provider must not bill HHSC for:
- (1) more hours than an individual's weekly authorization, except when services are delivered as described in §47.63(b)(2) of this chapter (relating to Service Delivery);
- (2) services delivered in a licensed facility, if the facility is required by the license to provide those services;
- (3) services provided outside the contracted service delivery area except if provided in compliance with §47.63(e) of this chapter; and
- (4) services or tasks that duplicate any services or tasks provided to the individual by another source.
- (b) Hourly rate. A provider must agree to accept the hourly rate authorized by HHSC.
- (c) Documentation. A provider must maintain the documentation described in this chapter to be eligible for reimbursement.
- (d) Rounding. A provider must bill HHSC for services in quarter-hour increments, rounding up to the next quarter-hour if the actual time worked is eight minutes or more, and rounding down to the previous quarter hour if the actual time worked is less than eight minutes.
- (e) Allowable tasks. A provider must bill HHSC only for the tasks described in §47.41 of this chapter (relating to Allowable Tasks).
Source Note:The provisions of this §277.89 adopted to be effective June 1, 2004, 29 TexReg 5113; amended to be effective June 1, 2009, 34 TexReg 2802; amended to be effective October 1, 2013, 38 TexReg 6621; amended to be effective September 1, 2014, 39 TexReg 6635; amended to be effective October 1, 2019, 44 TexReg 5138; transferred effective July 1, 2024, as published in the June 14, 2024, issue of the Texas Register, 49 TexReg 4436.