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New Information - HHSC Adopts Proposed Payment Rates for Attendant Services in Various Programs
Date: October 18, 2023
Attention: Providers and Financial Management Services Agencies (FMSAs)
Effective Date: September 1, 2023
Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that effective for dates of service on or after September 1, 2023, Texas Health and Human Services Commission (HHSC) shared payment rate changes for attendant services. In response to the 2024-25 General Appropriations Act, House Bill 1, 88th Legislature, Regular Session, 2023 (Article II, HHSC, Rider 30(a)), HHSC has increased the base wage for attendants from $8.11 to $10.60 per hour.
Background information: HHSC approved the payment rates for STAR Kids / STAR Health – Medically Dependent Children Program (MDCP) Waiver and Non-MDCP effective September 1, 2023.
Attendant services are non-technical medically related or personal care services provided to people at home or in community living settings. Long-term services and support (LTSS) attendant services include assisted living, employment services, habilitation, chores services, waiver transportation, in-home respite, supervised living, and residential support services.
How this impacts providers: For fee-for-Service claims, providers should continue to bill using their normal billing process. Individual providers require no additional action in terms on how they submit claims. TCHP is actively working to update our system. As a reminder, TCHP has 60 days to implement and reprocess claims associated with the fee schedule updates according to the Uniform Managed Care Terms and Conditions (UMCC). Providers do not need to appeal claims, as we will automatically reprocess claims once the fee schedule updates have taken place.
Next steps for providers: Once revised, individual service plans (ISPs) should be sent to FMSAs indicating the number of service hours available at the new rate and the effective date of the updated ISP.
If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org.
For access to all Provider Alerts,log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.