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Hearing. The Texas Health and Human Services Commission (HHSC) will conduct a public hearing to receive public comments on proposed Medical Policy Reviews, Special Review and HCPCS Quarterly Updates.
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/7914903065335951960
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 September 01, 2024:
Medical Policy Review
Influenza Vaccine-90653
Proposed to be effective October 01, 2024:
Medical Policy Review
COVID-19 End Dated Codes
Proposed to be effective December 01, 2024:
Special Review Updates
ASC/HASC End-Dated Codes
Proposed to be effective March 22, 2024:
HCPCS Quarterly Updates
Q2 HCPCS- Q0224
Q2 HCPCS Non Drugs- M0224
Proposed to be effective March 1, 2025:
HCPCS Quarterly Updates
Q2 HCPCS Non Drugs- TOS F
Q2 HCPCS Non Drugs- TOS 2
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;
Section 355.8121, Reimbursement to Ambulatory Surgical Centers;
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 on or before November 24, 2024. Interested parties may obtain a copy of the briefing packet on or after that date by contacting Provider Finance by telephone at (512) 730-7401; 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: (512) 730-7401
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.