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TITLE 1ADMINISTRATION
PART 15TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 354MEDICAID HEALTH SERVICES
SUBCHAPTER OELECTRONIC VISIT VERIFICATION
RULE §354.4005Personal Care Services that Require the Use of EVV
(a) A program provider must ensure a service provider uses EVV to document the provision of the following personal care services by the program provider:

  (1) in the traditional Medicaid service model also referred to as fee-for-service, including for members enrolled in STAR who receive PCS through fee-for-service:

    (A) CFC PAS;

     (B) CFC HAB;

     (C) PCS provided under Texas Health Steps CCP, including SRO; and

     (D) PCS-Behavioral Health provided under Texas Health Steps CCP, including SRO;

   (2) in the CLASS Program:

    (A) CFC PAS/HAB; and

    (B) in-home respite;

   (3) personal attendant services provided through the Community Attendant Services Program, including SRO;

   (4) in the DBMD Program:

    (A) CFC PAS/HAB; and

    (B) in-home respite;

   (5) personal attendant services provided through the FC Program, including SRO;

  (6) in the HCBS-AMH Program:

    (A) supported home living; and

     (B) in-home respite;

   (7) in the HCS Program:

    (A) CFC PAS/HAB;

     (B) in-home respite; and

     (C) in-home individualized skills and socialization provided to members with the residential type of "own/family home";

  (8) personal attendant services provided through the Primary Home Care Program, including SRO;

   (9) in the STAR Health Program:

    (A) CFC PAS, including SRO;

     (B) CFC HAB, including SRO; and

     (C) for a member in STAR Health MDCP:

      (i) in-home respite, with and without RN delegation, including SRO; and

       (ii) flexible family support, with and without RN delegation, including SRO;

   (10) in the STAR Kids Program:

    (A) CFC PAS, including SRO;

     (B) CFC HAB, including SRO; and

     (C) for a member in STAR Kids MDCP:

      (i) in-home respite, with and without RN delegation, including SRO; and

       (ii) flexible family support, with and without RN delegation, including SRO;

   (11) in the STAR+PLUS Program:

    (A) personal assistance services, including SRO;

     (B) CFC PAS, including SRO; and

     (C) CFC HAB, including SRO;

   (12) in the STAR+PLUS HCBS Program:

    (A) in-home respite care, including SRO;

     (B) protective supervision, including SRO;

    (C) personal assistance services, including SRO;

     (D) CFC PAS, including SRO; and

     (E) CFC HAB, including SRO;

   (13) in the STAR+PLUS MMP:

    (A) in-home respite care, including SRO;

     (B) protective supervision, including SRO;

    (C) personal assistance services, including SRO;

     (D) CFC PAS, including SRO; and

     (E) CFC HAB, including SRO;

   (14) in the TxHmL Program:

    (A) CFC PAS/HAB;

     (B) in-home respite; and

     (C) in-home individualized skills and socialization;

   (15) in-home respite provided in the YES Program; and

   (16) any other service required by federal or state mandates.

 (b) A CDS employer must ensure a service provider uses EVV to document the provision of the following personal care services through the CDS option:

  (1) in the traditional Medicaid service model also referred to as fee-for-service:

    (A) CFC PAS;

     (B) CFC HAB;

     (C) PCS provided under Texas Health Steps CCP; and

     (D) PCS-Behavioral Health provided under Texas Health Steps CCP;

   (2) in the CLASS Program:

    (A) CFC PAS/HAB; and

    (B) in-home respite;

   (3) personal attendant services provided through the Community Attendant Services Program;

   (4) in the DBMD Program:

    (A) CFC PAS/HAB; and

    (B) in-home respite;

   (5) personal attendant services provided through the FC Program;

  (6) in the HCS Program:

    (A) CFC PAS/HAB; and

     (B) in-home respite;

   (7) personal attendant services provided through the Primary Home Care Program;

  (8) in the STAR Health Program:

    (A) CFC PAS;

     (B) CFC HAB; and

     (C) for a member in STAR Health MDCP:

      (i) in-home respite, with and without RN delegation; and

       (ii) flexible family support, with and without RN delegation;

  (9) in the STAR Kids Program:

    (A) CFC PAS;

     (B) CFC HAB; and

     (C) for a member in STAR Kids MDCP:

      (i) in-home respite, with and without RN delegation; and

       (ii) flexible family support, with and without RN delegation;

  (10) in the STAR+PLUS Program:

    (A) personal assistance services;

     (B) CFC PAS; and

     (C) CFC HAB;

   (11) in the STAR+PLUS HCBS Program:

    (A) in-home respite care;

     (B) protective supervision;

     (C) personal assistance services;

     (D) CFC PAS; and

     (E) CFC HAB;

   (12) in the STAR+PLUS MMP:

    (A) in-home respite care;

     (B) protective supervision;

     (C) personal assistance services;

     (D) CFC PAS; and

     (E) CFC HAB; and

   (13) in the TxHmL Program:

    (A) CFC PAS/HAB;

     (B) in-home respite; and

     (C) in-home individualized skills and socialization.
Source Note: The provisions of this §354.4005 adopted to be effective January 1, 2024, 48 TexReg 7171

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