| (a) Authorized home health nursing and aide services
provided to eligible Medicaid recipients are reimbursed the lesser
of the billed amount or the Medicaid reimbursement rate established
by HHSC.
(b) HHSC reviews the fees for nursing and aide services
at least once every two years based upon:
(1) analysis of the Centers for Medicare & Medicaid
Services fees for the same or similar services;
(2) analysis of Medicaid fees for the same or similar
services in other states; and
(3) analysis of fees paid under commercial insurance
for the same or similar services.
(c) HHSC may use data sources or methodologies other
than those listed in subsection (b) of this section to establish Medicaid
fees for home health services when HHSC determines that the methodologies
in subsection (b) of this section are unreasonable or insufficient.
(d) Reimbursement for Physical, Occupational, and Speech
Therapy Services is described in §355.8097 of this title (relating
to Reimbursement for Physical, Occupational, and Speech Therapy Services).
(e) Fees for home health services will be adjusted
within available funding as described in §355.201 of this title
(relating to Establishment and Adjustment of Reimbursement Rates by
the Health and Human Services Commission).
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