Proposed Medicaid Payment Rates for Medical Policy Reviews Agenda

Hearing. The Texas Health and Human Services Commission (HHSC) will conduct a public hearing to receive public comments on proposed Medicaid payment rates for Medical Policy Reviews.

This hearing will be conducted as an online event only. To join the hearing from your computer, tablet, or smartphone, register for the hearing in advance using the following link:

Registration URL: 
https://attendee.gotowebinar.com/register/4297425144641106782

After registering, you will receive a confirmation email containing information about joining the webinar. Instructions for dialing-in by phone will be provided after you register.

If you are new to GoToWebinar, please download the GoToMeeting app at https://global.gotomeeting.com/install/626873213 before the hearing starts.

A recording of the hearing will be archived and can be accessed on demand at https://hhs.texas.gov/about-hhs/communications-events/live-archived-meetings under the “Archived” tab. The hearing will be held in compliance with Texas Human Resources Code Section 32.0282, which requires public notice of and hearings on proposed payment rates.

Proposal.  The effective date of the proposed payment rates for the topics presented during the rate hearing will be as follows:

Proposed to be effective January 24, 2022:

Medical Policy Review

Policy Att A(1): COVID-19 End-dated Codes 

Proposed to be Effective April 5, 2022:

Medical Policy Review

Policy Att A(2): COVID-19 End-dated Codes

Proposed to be Effective November 30, 2022:

Medical Policy Review

Policy Att A(3): COVID-19 End-dated Codes 

Proposed to be Effective January 26, 2023:

Medical Policy Review

Policy Att A(4): COVID-19 End-dated Codes 

Proposed to be Effective June 1, 2023:

Medical Policy Review

Policy Att A(5): COVID-19 End-dated Codes

Policy Att A(6): COVID-19 End-dated Dental Codes

Proposed to be Effective September 11, 2023:

Medical Policy Review

Policy Att A(7): COVID-19 End-dated Codes 

Proposed to be Effective October 3, 2023:

Medical Policy Review

Policy Att A(8): COVID-19 End-dated Codes 

Proposed to be Effective May 1, 2024:

Medical Policy Review

Policy Att A(10): Monkeypox Vaccine

Proposed to be Effective September 30, 2024:

Medical Policy Review

Policy Att A(9): COVID-19 End-dated Dental Codes

Methodology and Justification. The proposed payment rates were calculated in accordance with Title 1 of the Texas Administrative Code:

Section 355.8085, Reimbursement Methodology for Physicians and Other Practitioners; and

Section 355.8441, Reimbursement Methodologies for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Services (also known as Texas Health Steps).

Rate Hearing Packet. A briefing packet describing the proposed payment rates will be made available at https://pfd.hhs.texas.gov/rate-packets no later than July 23, 2024. Interested parties may obtain a copy of the briefing packet on or after that date by contacting Provider Finance by telephone at (737) 867-7817; by fax at (512) 730-7475; or by e-mail at PFDAcuteCare@hhs.texas.gov.

Written Comments.  Written comments regarding the proposed payment rates may be submitted instead of, or in addition to, oral testimony until 5 p.m. the day of the hearing. Written comments may be sent by U.S. mail, overnight mail, special delivery mail, fax, or e-mail:

U.S. Mail
Texas Health and Human Services Commission
Attention: Provider Finance, Mail Code H-400
P.O. Box 149030
Austin, Texas 78714-9030

Overnight mail or special delivery mail
Texas Health and Human Services Commission
Attention: Provider Finance, Mail Code H-400
North Austin Complex
4601 W Guadalupe St.
Austin, Texas 78751

Phone number for package delivery: (737) 867-7817

Fax 
Attention: Provider Finance at (512) 730-7475

E-mail
PFDAcuteCare@hhs.texas.gov

Preferred Communication. For quickest response please use e-mail or phone, if possible, for communication with HHSC related to this rate hearing.

Persons with disabilities who wish to participate in the hearing and require auxiliary aids or services should call Provider Finance at (512) 730-7401 at least 72 hours before the hearing so appropriate arrangements can be made.