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TITLE 40SOCIAL SERVICES AND ASSISTANCE
PART 1DEPARTMENT OF AGING AND DISABILITY SERVICES
CHAPTER 9INTELLECTUAL DISABILITY SERVICES--MEDICAID STATE OPERATING AGENCY RESPONSIBILITIES
SUBCHAPTER DHOME AND COMMUNITY-BASED SERVICES (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
RULE §9.192Service Limits

(a) The following limits apply to an individual's HCS Program services:

  (1) for adaptive aids, $10,000 during an IPC year;

  (2) for dental treatment, $2,000 during an IPC year;

  (3) for minor home modifications and pre-enrollment minor home modifications combined:

    (A) $7,500 during the time the individual is enrolled in the HCS Program, which may be paid in one or more IPC years; and

    (B) after reaching the $7,500 limit described in subparagraph (A) of this paragraph, a maximum of $300 for repair and maintenance during the IPC year;

  (4) for respite, 300 hours during an IPC year; and

  (5) for TAS:

    (A) $2,500 if the applicant's proposed initial IPC does not include residential support, supervised living, or host home/companion care; or

    (B) $1,000 if the applicant's proposed initial IPC includes residential support, supervised living, or host home/companion care.

(b) An individual may receive TAS only once in the individual's lifetime.

(c) A program provider may request, in accordance with the HCS Program Billing Guidelines, authorization of a requisition fee:

  (1) for dental treatment that is in addition to the $2,000 service limit described in subsection (a)(2) of this section; or

  (2) for a minor home modification that is in addition to the $7,500 service limit described in subsection (a)(3)(A) of this section.


Source Note: The provisions of this §9.192 adopted to be effective December 1, 2011, 36 TexReg 8043; amended to be effective September 1, 2014, 39 TexReg 6516; amended to be effective November 15, 2015, 40 TexReg 7827; amended to be effective March 20, 2016, 41 TexReg 1867

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