The Department of Aging and Disability Services (DADS) released seven information letters:
- DADS Supplemental Reimbursement for Ventilators and Tracheostomies
In a letter to Nursing Facility (NF) providers, DADS reminded them about the reimbursement rules at Texas Administrative Code, Title 1, Part 15, Chapter 355, §355.307(b)(3)(F) and(G), which states that qualifying ventilator-dependent residents and qualifying children with tracheostomies requiring daily care may receive a supplement to the per diem rate. Download the letter for more information.
- Reimbursement Rates for Out-of-Home Respite Services Provided by NFs
Effective December 1, 2008, new Medically Dependent Children Program reimbursement rates will include out-of-home respite rates for individuals who receive 24-hour ventilator care (new service code 11FA), less than 24-hour ventilator care (new service code 11FB), and tracheostomy care (new service code 11FC) in a NF. Download the letter for more information.
- Expansion of the Consumer Directed Services (CDS) Option to Nursing and Therapy Services
Effective December 1, 2008, the ICM CDS option will be expanded to include nursing and therapy services. Download the three-page letter for details.
- Integrated Care Management (ICM) Program: Appeal, Fair Hearing and Complaint Coordination (Replaces IL 08-08)
In a letter to ICM Long Term Services and Supports providers, DADS summarized the revised ICM Appeals process and included additional operational procedures related to ICM appeals that were not addressed in Information Letter No. 08-08. Download the six-page letter and attachment.
- Rates and Billing Procedure for Consumer Directed Services (CDS) in Consumer Managed Personal Attendant Services (CMPAS)
DADS informed CMPAS Contract Managers and Providers that effective December 1, 2008, CMPAS contract managers must update the Long Term Care Provider system for CMPAS/CDS contracts with the code 63V for payment. Download the two-page letter for details.
- Billing for Dental Services
DADS informed Home and Community-Based Services and Texas Home Living providers that a new Health Care Procedure Coding System has been added for anesthesiology services. Effective December 3, 2008, providers must request reimbursement authorizations separately for dental and anesthesiology services. For more information, download the letter.
- Billing for Nursing Aide Training
DADS reminded NFs how to bill for Nurse Aide Training (NAT) classes/testing. NFs must contact the Texas Medicaid Healthcare Partnership and confirm that a Service Code 6 (NAT) record and a rate record are included in the contract. Download the four-page letter for more information.
