Clarification of Billing Units for HCS and TxHmL Hourly Services

June 20, 2022

Some Home and Community-based Services and Texas Home Living providers have reported having issues entering the appropriate units of service in TexMedConnect when billing hourly service components and subcomponents.

The HCS and TxHmL Program Billing Requirements and Community First Choice Billing Requirements for HCS and TxHmL Program Providers are being updated to provide clarification. These are scheduled for publication by Sept. 1.

To provide clarity in the interim, the Appendix III Conversion Table has been updated to be a standalone document. It’s available to view on the Long-term Care Provider Resources webpage and Handbooks webpage.

Providers should use the table to help with converting service time to units of service for applicable HCS and TxHmL Program services and for CFC Personal Assistance Services/Habilitation provided to people receiving HCS and TxHmL Program services.

The rates for all hourly services are based on one hour of service but can be billed in quarter-hour increments. When completing individual plans of care, viewing Medicaid Eligibility and Service Authorization Verification, and entering claims, one hour is one unit.

Email TxHmL Policy for questions.