Comprehensive Rehabilitation Services (CRS) Standards for Providers

Revision 19-2; Effective June 1, 2019

The following changes were made:

Chapter	Title	Change
10.4	Interdisciplinary Team Meetings	Adds that Interdisciplinary Team Meeting is the same as Medical Team Conference.
Appendix A	Definitions	Adds Medical Team Conference.
Appendix B	Post-Acute Rehabilitation Core Services Modality and Staff Qualifications	Adds Certified Music Therapist to Music Therapy under Core Services. Adds Case Management to Modality and Staff Qualifications for PARS Non-Residential.

Revision 19-1; Effective May 1, 2019

The following changes were made:

Chapter	Title	Change
1	CRS Program Overview	Updates CRS contact information.
1.2	Referrals to CRS	Adds the referral form, process and contact information.
3.2	Language Services	Adds Language Services Standard for providers.
3.4	Facility Safety Protocol	Updates when and where to report incidents to CRS. Adds substance abuse, inappropriate behavior that may have participant dismissed from facility, and elopement.
4.5	Staff Training	Adds Cardiopulmonary arrest (CPR), Basic Life Support (BLS) training and Fall Prevention.
4.6	Staff Qualifications	Adds qualification of Community Independence Supports (CIS).
5.1	Overview	Updates when and where to report incidents to CRS.
5.3	CRS Service Number	Adds ombudsman’s number and CRS email because CRS does not have a direct phone line.
5.4	Grievance Procedure	Updates ombudsman’s contact information.
6.4	Invoices	Updates to match updated TAC §20.487. Adds CRS Program responsibility.
6.5	Use of Comparable Benefits or Third Party Billing	Adds amount CRS pays if a participant is using their insurance's out of network provider.
7.2	Quality Reviews	Adds services that are billed and paid based on services and contracted rate.
8	Compliance and Quality Review for Traumatic Brain Injury	Changes Utilization Review to Compliance and Quality Review.
8.2	Review Types	Notes changes to types of review names. Adds purchasing review.
8.4	Prospective Reviews	Changes title to Clinical Reviews and adds detail of what a clinical review covers.
8.5	Concurrent and/or Retrospective Reviews	Changes title to Purchasing Reviews and adds detail of what a clinical review covers.
9.1	Overview	Adds changes and updates to provider’s admission policies and procedures including that they need to be reported to CRS when complete. Moves referral information to Chapter 1, Section 2.
9.2	Intake Process	Adds information that providers must have participants sign an intake acknowledgement form and must place the form in the participant’s file.
10.2	Assessment	Adds information about discharge planning utilizing the wraparound approach. Adds mental health and substance misuse needs.
10.3	Development of Individualized Service Plan	Adds this section.
10.4	Interdisciplinary Team Meetings	Adds the professional staff who are included in the IDT team and credentialing information needed. Adds IDT team process including changing meetings to every 30 days, what needs reviewing for the participant and how to notify the IDT team.
10.5	Behavior Management Plans	Adds information about behavior management plans and what they address. Adds information about who signs the informed conformed consent.
10.6	Emergency Restrictive Procedures	Adds procedure for minors who receive chemical or physical restraints more than once within 30 days.
11.2	Required Documentation	Adds that PM&R physician overseeing the participant’s care while in ICMRS is a separate service requiring pre-authorization.
11.3	Assessment, Planning and Interdisciplinary Meetings	Adds Assessment, Planning and Interdisciplinary Meetings section.
11.4	Billing Guidelines	Updates billing guidelines and when invoices must be submitted.
12.1	Overview	Clarifies what outpatient therapy services refer to and where they are referenced.
12.3	Assessment, Planning and Interdisciplinary Meetings	Adds Assessment, Planning and Interdisciplinary Meetings section. Notes that outpatient services differ from Post-acute rehabilitation services (PARS) non-residential services.
12.4	Billing Guidelines	Updates billing guidelines and when invoices must be submitted.
13.1	Overview	Adds link for updated rates.
13.2	Required Documentation	Adds information for providers about required documentation.
13.3	Assessment and Planning	Changes title to Assessment, Planning and Interdisciplinary Meetings. Moves part of this section to Chapter 10, Section 2.
13.6.1	Licensure and Accreditation	Changes Department of Aging and Disability Services to Texas Health and Human Services.
13.6.7	Utilization Review	Removes this section.
13.6.7	Exceptions and Limitations	Updates therapeutic passes.
13.7	Non-Residential	Adds post-acute rehabilitation non-residential services to also include case management, community independence supports, medical team conferences.
13.7.1	Licensure and Accreditation	Changes Department of Aging and Disability Services to Texas Health and Human Services.
13.7.3	Billing Guidelines	Adds uploading into CRS Data Reporting System.
14.1	Overview	Adds information about meeting treatment goals.
14.2	Durable Medical Equipment	Adds this section.
14.3	Home Modification	Adds this section.
14.4	Required Documentation	Adds requirements for receiving durable medical equipment.
14.5	Billing Guidelines	Updates billing guideline requirements for providers for ancillary goods and services and DME.
14.6	Exceptions and Limitations	Updates this section with what is covered under the CRS program as well as when competitive bids are required.
15.1	Overview	Adds information about discharge planning.
15.3	Termination from Program	Adds information about providers documenting attempted interventions.
Appendix A	Definitions	Adds the following terms: Abuse Ancillary services Assistive Technology Authorized representative Certified Brain Injury Specialist (CBIS) Community Independence Supports (CIS) Comparable benefits Competitive bid Compliance Glasgow Coma Scale (GCS) Texas Identification Number (TIN) Edits the following terms: Mental restoration services to mental health counseling Paraprofessional Removes the following: Utilization Review
Appendix B	Post-Acute Rehabilitation Core Services Modality and Staff Qualifications	Changes code numbering. Changes Mental Restoration to Mental Health Counseling. Changes Modality and Staff Qualifications for PARS Non-Residential.
Appendix C	Base Services and Tier Structure	Changes title to PARS Residential Base Services and Tier Structure
Appendix D	Service Record for CRS Data Reporting System	Adds clarification text.

Revision 17-1; Effective Sept. 1, 2017

The following changes were made:

Chapter	Title	Change
13.6.2	Billing Guidelines - Tiers	Adds based on the consumer’s need, which will be determined during the initial pre-admission assessment, the provider may request an admission tier of level 2 through level 8. This request is to be submitted in writing using Form 3149, Comprehensive Rehabilitation Services Request for Tier Change, or included in the pre-admission evaluation, which identifies services needed, frequency, duration and requested tier. Explains when submitting an invoice, Post-Acute Rehabilitation providers are required to submit a monthly summary that includes a descriptive breakdown of services provided; frequency, duration, progress, or lack of progress made towards the consumer's goals; actions to be taken; and preliminary discharge information. Providers are also required to upload service record details of daily services provided in the CRS Data Reporting System, per Chapter 13.2, Required Documentation. Providers will only be required to submit daily therapy documentation if a consumer's file is randomly selected for utilization review. The provider will receive a written request with a time frame outlining when documentation is to be returned to the CRS requestor.