Claims (Provider Claims Hotline)
- Nursing facility/hospice billing: 512-438-2200, Option 1
- Emergency dental, rehab/specialized services: 512-438-2200, Option 6
Culture Change
Nursing facility inquiries related to culture change principles, philosophy or practice (e.g. person-directed care, related regulations, home-like environment):
Long-term Care Regulatory Nursing Facility, Policy or Rule Questions
- Email HHSC LTCR Policy or call 512-438-3161.
How to Become a Nursing Facility Provider
In order to become a nursing facility provider, you must first apply for a license. Facilities may wish to be private pay (facility with no certification) or Medicaid - and/or Medicare-certified. To contact provider licensure and certification, call 512-438-2630.
How to Obtain a Medicaid Contract
To contact Contract Administration and Provider Monitoring, call 512-438-3390 or email HHSC CAPM NF ICF Contracts.
Minimum Data Set (MDS) Resources
- MDS Automation Coordinator, email HHSC RSD MDS Support
- MDS RAI Coordinator, email HHSC RAI MDS Support.
- Texas MDS website
Preadmission Screening and Resident Review (PASRR)
- PASRR website
- Contact PASRR staff: call 855-435-7180 or email HHSC PASRR Support
- Customized Manual Wheelchair and Durable Medical Equipment benefits (specialized services only)
Quality Monitoring Program (QMP)
- QMP Website
- Contact QMP staff: call 512-438-4399 or email HHS Quality Monitoring Program