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Texas Administrative Code (Last Updated: March 27,2024) |
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TITLE 1. ADMINISTRATION |
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PART 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION |
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CHAPTER 354. MEDICAID HEALTH SERVICES |
| SUBCHAPTER A. PURCHASED HEALTH SERVICES |
| DIVISION 1. MEDICAID PROCEDURES FOR PROVIDERS |
| § 354.1001. Claim Information Requirements |
| § 354.1002. Compliance with Civil Rights Act |
| § 354.1003. Time Limits for Submitted Claims |
| § 354.1004. Retention of Records |
| § 354.1005. Unauthorized Charges |
| DIVISION 2. MEDICAID VISION CARE PROGRAM |
| § 354.1015. Benefits and Limitations |
| § 354.1017. Specifications for Eyewear |
| § 354.1021. Additional Claims Information Requirements |
| § 354.1023. Optometric Services Provider |
| § 354.1025. Competitive Procurement of Vision Care Services |
| DIVISION 3. MEDICAID HOME HEALTH SERVICES |
| § 354.1031. General |
| § 354.1033. Provider Participation Requirements |
| § 354.1035. Recipient Qualifications for Home Health Services |
| § 354.1037. Written Plan of Care |
| § 354.1039. Benefits and Limitations of Home Health Services |
| § 354.1040. Requirements for Wheeled Mobility Systems |
| § 354.1041. Benefits for Medicare/Medicaid Recipients |
| § 354.1042. Supplies Provided by a Pharmacy |
| § 354.1043. Competitive Procurement of Durable Medical Equipment (DME) and Supplies |
| DIVISION 4. MEDICAID CHIROPRACTIC SERVICES |
| § 354.1051. Additional Claim Information Requirements |
| § 354.1052. Authorized Chiropractic Services |
| DIVISION 5. PHYSICIAN AND PHYSICIAN ASSISTANT SERVICES |
| § 354.1060. Definitions |
| § 354.1061. Additional Claim Information Requirements |
| § 354.1062. Authorized Physician Services |
| § 354.1063. Preventable Adverse Events |
| § 354.1064. Anesthesiologist Assistant Conditions of Participation |
| § 354.1065. Anesthesiologist Assistant Benefits and Limitations |
| § 354.1066. Physician Assistant Conditions of Participation |
| § 354.1067. Physician Assistant Benefits and Limitations |
| § 354.1069. Sign Language Interpreter Services |
| DIVISION 6. HOSPITAL SERVICES |
| § 354.1070. Definitions |
| § 354.1071. Additional Claim Information Requirements |
| § 354.1072. Authorized Inpatient Hospital Services |
| § 354.1073. Authorized Outpatient Hospital Services |
| § 354.1075. Hospitalization (Dental Care Only) for Individuals under Age 21 Years |
| § 354.1077. Provider Participation Requirements |
| DIVISION 7. LABORATORY, X-RAY, AND RADIATION THERAPY |
| § 354.1091. Additional Claim Information Requirements |
| § 354.1092. Authorized Services |
| DIVISION 8. PODIATRY SERVICES |
| § 354.1101. Additional Claim Information Requirements |
| § 354.1102. Authorized Podiatry Services |
| DIVISION 9. AMBULANCE SERVICES |
| § 354.1111. Definitions |
| § 354.1113. Additional Claim Information Requirements |
| § 354.1115. Authorized Ambulance Services |
| DIVISION 10. DEFINITIONS |
| § 354.1121. Definitions |
| DIVISION 11. GENERAL ADMINISTRATION |
| § 354.1131. Payments to Eligible Providers |
| § 354.1133. Parental Accompaniment Requirement |
| § 354.1135. Claims Procedures |
| § 354.1137. Review of Questionable Claims |
| § 354.1139. Verification of Cost Data |
| § 354.1141. Notification to Eligible Providers |
| § 354.1143. Coordination of Medicaid with Medicare Parts A, B, and C |
| § 354.1145. Nonliability |
| § 354.1147. Medicaid Fee Schedule |
| § 354.1149. Exclusions and Limitations |
| § 354.1151. Freedom of Choice |
| § 354.1153. Subrogation |
| § 354.1155. Confidentiality of Information |
| § 354.1157. Potential Fraud, Program Abuse, and Other Misutilization |
| § 354.1159. Utilization Review |
| § 354.1161. Provider Re-enrollment or Provider Contract or Agreement Modification |
| § 354.1163. Fair Hearings |
| § 354.1165. Free Services for Recipients |
| § 354.1167. Reimbursement for Abortions |
| § 354.1169. Ectopic Pregnancy |
| § 354.1171. Use of Drugs or Devices to Prevent Implantation of the Fertilized Ovum |
| § 354.1175. Organ Transplants |
| § 354.1181. Provider Compliance with the Clinical Laboratory Improvement Amendments of 1988 |
| § 354.1183. Provider Compliance with the Mammography Quality Standards Act of 1992 |
| § 354.1185. Provider Compliance with Durable Medical Equipment (DME) Certification Requirements |
| § 354.1186. Requirements for the Health Passport |
| § 354.1187. Responsibilities of Third-Party Billing Vendors |
| § 354.1189. Acute Care Medicaid Billing Coordination System |
| § 354.1190. Medicaid Provider Database |
| DIVISION 12. RURAL HEALTH CLINICS |
| § 354.1201. Authorized Services by Rural Health Clinics |
| § 354.1202. Conditions for Payments to Rural Health Clinics |
| § 354.1203. Relationship of Recipient's Treating Physician to Rural Health Clinics |
| DIVISION 13. AMBULATORY SURGICAL CENTERS |
| § 354.1211. Conditions for Participation |
| § 354.1212. Services and Limitations |
| DIVISION 14. DENTISTS' SERVICES |
| § 354.1221. Authorized Dentists' Services |
| DIVISION 15. HEARING AID SERVICES |
| § 354.1231. Benefits and Limitations |
| § 354.1233. Requirements for Hearing Aid Services |
| § 354.1235. Requirements for Provider Participation |
| DIVISION 16. MIDWIFE SERVICES |
| § 354.1251. Benefits and Limitations |
| § 354.1252. Certified Nurse Midwife: Conditions for Participation |
| § 354.1253. Licensed Midwife: Conditions for Participation |
| DIVISION 17. BIRTHING CENTER SERVICES |
| § 354.1261. Benefits and Limitations |
| § 354.1262. Conditions for Participation |
| DIVISION 18. MATERNITY CLINIC SERVICES |
| § 354.1271. Benefits and Limitations |
| § 354.1272. Conditions for Participation |
| § 354.1275. Monitoring |
| DIVISION 19. PSYCHOLOGISTS' SERVICES |
| § 354.1281. Benefits and Limitations |
| § 354.1282. Conditions of Participation |
| DIVISION 20. PHYSICAL THERAPISTS' SERVICES |
| § 354.1291. Benefits and Limitations |
| § 354.1292. Conditions for Participation |
| DIVISION 21. CERTIFIED REGISTERED NURSE ANESTHETISTS' SERVICES |
| § 354.1301. Benefits and Limitations |
| § 354.1302. Conditions for Participation |
| DIVISION 22. SUBSTANCE ABUSE AND DEPENDENCY TREATMENT SERVICES |
| § 354.1311. Benefits and Limitations |
| § 354.1312. Conditions for Participation |
| DIVISION 23. FEDERALLY QUALIFIED HEALTH CENTER SERVICES |
| § 354.1321. Benefits and Limitations |
| § 354.1322. Provider Participation Requirements |
| § 354.1323. Reviews/Appeals |
| DIVISION 24. NURSE PRACTITIONER AND CLINICAL NURSE SPECIALIST SERVICES |
| § 354.1331. Benefits and Limitations |
| § 354.1332. Conditions for Participation |
| DIVISION 25. SCHOOL HEALTH AND RELATED SERVICES |
| § 354.1341. Benefits and Limitations |
| § 354.1342. Conditions for Participation |
| DIVISION 26. COORDINATED CARE |
| § 354.1351. Coordinated Care Pilot Project |
| DIVISION 27. COMMUNITY FIRST CHOICE |
| § 354.1360. Purpose |
| § 354.1361. Definitions |
| § 354.1362. Eligibility |
| § 354.1363. Assessment |
| § 354.1364. Services and Limitations |
| § 354.1365. Provider Qualifications |
| § 354.1366. Consumer Directed Services and Service Responsibility Option |
| § 354.1367. Person-Centered Service Plan |
| § 354.1368. Fair Hearing |
| § 354.1369. Attendant Base Wage |
| DIVISION 28. TUBERCULOSIS |
| § 354.1371. Tuberculosis Clinic Benefits and Limitations |
| DIVISION 29. LICENSED PROFESSIONAL COUNSELORS, LICENSED CLINICAL SOCIAL WORKERS, AND LICENSED MARRIAGE AND FAMILY THERAPISTS |
| § 354.1381. Benefits and Limitations |
| § 354.1382. Conditions for Participation |
| DIVISION 30. IN-HOME TOTAL PARENTERAL HYPERALIMENTATION SERVICES |
| § 354.1391. In-home Total Parenteral Hyperalimentation Services |
| DIVISION 31. IN-HOME RESPIRATORY THERAPY SERVICES FOR VENTILATOR-DEPENDENT PERSONS |
| § 354.1401. In-home Respiratory Therapy Services for Ventilator-Dependent Persons |
| DIVISION 32. TEXAS MEDICAID WELLNESS PROGRAM |
| § 354.1415. Vendor Requirements and Conditions for Participation |
| § 354.1416. Eligibility Criteria |
| § 354.1417. Definitions for Wellness Services |
| DIVISION 33. ADVANCED TELECOMMUNICATIONS SERVICES |
| § 354.1430. Definitions |
| § 354.1432. Telemedicine and Telehealth Benefits and Limitations |
| § 354.1434. Home Telemonitoring Benefits and Limitations |
| § 354.1435. Provision of Behavioral Health Services through an Audio-Only Platform |
| § 354.1436. Provision of Non-behavioral Health Services Using an Audio-only Platform |
| DIVISION 34. OUT-OF-STATE SERVICES |
| § 354.1440. Medical Care or Services Provided to Medicaid Recipients Outside of Texas |
| DIVISION 35. REIMBURSEMENT ADJUSTMENTS FOR POTENTIALLY PREVENTABLE EVENTS |
| § 354.1445. Potentially Preventable Readmissions |
| § 354.1446. Potentially Preventable Complications |
| SUBCHAPTER B. GENERAL PROVISIONS |
| § 354.1450. Audits of Medicaid Providers |
| § 354.1451. Medicaid Recovery Audit Contractor Program |
| § 354.1452. Provider Marketing |
| SUBCHAPTER D. TEXAS HEALTHCARE TRANSFORMATION AND QUALITY IMPROVEMENT PROGRAM |
| DIVISION 1. GENERAL |
| § 354.1601. Introduction |
| § 354.1602. Definitions |
| DIVISION 2. REGIONAL HEALTHCARE PARTNERSHIPS |
| § 354.1611. Organization |
| § 354.1612. Anchors |
| § 354.1613. Participants |
| DIVISION 3. RHP PLAN CONTENTS AND APPROVAL |
| § 354.1621. RHP Plan |
| § 354.1622. RHP Plan Assessment |
| § 354.1623. RHP Plan Modifications and the Addition of Three-Year DSRIP Projects |
| § 354.1624. Independent Assessment of DSRIP Projects |
| DIVISION 4. DSRIP |
| § 354.1631. DSRIP Categories |
| § 354.1632. DSRIP Requirements for Regional Healthcare Partnerships |
| § 354.1633. DSRIP Requirements for Performers |
| § 354.1634. Waiver Pool Allocation |
| § 354.1635. DSRIP Project Valuation |
| § 354.1636. Payment for DSRIP Performance |
| § 354.1637. DSRIP Project Termination and Payment Recoupment |
| DIVISION 5. ACTIONS IN PREPARATION FOR EXTENSION OF THE DSRIP PROGRAM |
| § 354.1641. Definitions |
| § 354.1643. Medicaid and Low-income or Uninsured (MLIU) Quantifiable Patient Impact (QPI) |
| § 354.1645. Electing to Continue a DSRIP Project in the Waiver Extension Period |
| § 354.1647. Requests for Adjustments to Certain DSRIP Projects |
| § 354.1649. Certain Requirements for the Planned Transition Year and their Exceptions |
| DIVISION 6. DSRIP PROGRAM DEMONSTRATION YEAR 6 |
| § 354.1661. Definitions |
| § 354.1663. Medicaid and Low-income or Uninsured (MLIU) Quantifiable Patient Impact (QPI) |
| § 354.1665. Demonstration Year 6 DSRIP Pool Funding and Distribution |
| § 354.1667. Requirements for Continuing DSRIP Projects |
| § 354.1669. Requirements for Combining Certain DSRIP Projects |
| § 354.1671. DSRIP Requirements for Uncompensated Care Hospitals |
| § 354.1673. Remaining DSRIP Funds |
| § 354.1675. Anchor Requirements |
| DIVISION 7. DSRIP PROGRAM DEMONSTRATION YEARS 7-8 |
| § 354.1691. Definitions |
| § 354.1693. Regional Healthcare Partnerships (RHPs) |
| § 354.1695. Participants |
| § 354.1697. RHP Plan Update |
| § 354.1699. RHP Plan Update Review |
| § 354.1701. RHP Plan Update Modifications |
| § 354.1703. Independent Assessor |
| § 354.1705. Categories |
| § 354.1707. Performer Valuations |
| § 354.1709. Category A Requirements for Performers |
| § 354.1711. Category B Requirements for Performers |
| § 354.1713. Category C Requirements for Performers |
| § 354.1715. Category D Requirements for Performers |
| § 354.1717. Uncompensated Care (UC) Hospital Requirements |
| § 354.1719. Disbursement of Funds |
| § 354.1721. Remaining Funds for Demonstration Years (DYs) 7-8 |
| DIVISION 8. DSRIP PROGRAM DEMONSTRATION YEARS 9-10 |
| § 354.1729. Definitions |
| § 354.1731. Medicaid and Low-income or Uninsured Patient Population by Provider |
| § 354.1733. Regional Healthcare Partnerships (RHPs) |
| § 354.1735. Participants |
| § 354.1737. RHP Plan Update for DY9-10 |
| § 354.1739. RHP Plan Update Review |
| § 354.1741. RHP Plan Update Modifications |
| § 354.1743. Independent Assessor |
| § 354.1745. Categories |
| § 354.1747. Performer Valuations |
| § 354.1749. Category A Requirements for Performers |
| § 354.1751. Category B Requirements for Performers |
| § 354.1753. Category C Requirements for Performers |
| § 354.1755. Category D Requirements for Performers |
| § 354.1757. Disbursement of Funds |
| SUBCHAPTER F. PHARMACY SERVICES |
| DIVISION 1. PARTICIPATION |
| § 354.1801. Requirements for Participation |
| § 354.1803. Confidentiality |
| § 354.1805. Nondiscrimination |
| § 354.1807. Access to Records |
| § 354.1809. Denial or Termination of Participation |
| § 354.1811. Sanctions |
| § 354.1813. Placing a Pharmacy Provider on Vendor Hold |
| DIVISION 2. ADMINISTRATION |
| § 354.1831. Covered Drugs |
| § 354.1832. Prior Authorization Procedures |
| § 354.1833. Pharmacy Services |
| § 354.1835. Prescriber Identification Numbers |
| § 354.1837. Evidence of Eligibility |
| DIVISION 3. MEDICATIONS |
| § 354.1851. Substitution of One Drug for Another in a Prescription |
| § 354.1853. Specialty Drugs |
| DIVISION 4. LIMITATIONS |
| § 354.1861. Availability of Funds |
| § 354.1863. Prescription Requirements |
| § 354.1867. Refills |
| § 354.1868. Exceptions in Disasters |
| § 354.1871. Advertising |
| § 354.1873. Freedom of Choice |
| § 354.1875. Limitations on Provider Charges to Recipients |
| § 354.1877. Quantity Limitations |
| DIVISION 5. AUDITS |
| § 354.1891. Vendor Drug Providers Subject to Audit |
| § 354.1892. Exception Notification |
| DIVISION 6. PHARMACY CLAIMS |
| § 354.1901. Pharmacy Claims |
| § 354.1905. Claim Adjustments |
| § 354.1907. Unacknowledged Claims |
| § 354.1909. Submittal of Special Claims |
| § 354.1911. Electronic Data Transmission Vendors (Switches) |
| DIVISION 7. TEXAS DRUG CODE INDEX--ADDITIONS, RETENTIONS, AND DELETIONS |
| § 354.1921. Addition of Drugs to the Texas Drug Code Index |
| § 354.1923. Review and Evaluation |
| § 354.1924. Preferred Drug List |
| § 354.1925. Resubmittal of a Denied Request |
| § 354.1927. Retention and Deletion of Drugs |
| DIVISION 8. DRUG UTILIZATION REVIEW BOARD |
| § 354.1941. Drug Utilization Review Board |
| § 354.1942. Conflict of Interest Policy |
| SUBCHAPTER I. MEDICAID PROGRAM APPEALS PROCEDURES |
| DIVISION 1. GENERAL |
| § 354.2201. Definitions |
| § 354.2203. Recipients with Special Needs or Disabilities |
| DIVISION 2. RECIPIENT NOTICE AND FAIR HEARING |
| § 354.2211. Recipient Notice and Fair Hearing Request |
| § 354.2213. Maintaining Benefits or Services |
| § 354.2215. Fair Hearing |
| DIVISION 3. APPEALS |
| § 354.2217. Provider Appeals and Reviews |
| SUBCHAPTER J. MEDICAID THIRD PARTY RECOVERY |
| DIVISION 1. GENERAL PROVISIONS |
| § 354.2301. Basis and Purpose |
| § 354.2302. Definitions |
| DIVISION 2. APPLICANT AND RECIPIENT REQUIREMENTS |
| § 354.2311. Applicant and Recipient Assignment of Rights |
| § 354.2313. Duty of Applicant or Recipient to Inform and Cooperate |
| § 354.2315. Duty of Attorney or Representative of a Recipient |
| DIVISION 3. PROVIDER REQUIREMENTS |
| § 354.2321. Provider Billing and Recovery From Third Party Resources |
| § 354.2322. Provider Billing and Recovery from Other Liable Third Parties |
| DIVISION 4. DUTIES OF THE COMMISSION |
| § 354.2331. Requests for Information |
| § 354.2332. Distribution of Recoveries |
| § 354.2333. Waiver Authority of the Executive Commissioner |
| § 354.2334. Notices and Payments |
| DIVISION 5. HEALTH INSURER REQUIREMENTS |
| § 354.2341. Third Party Health Insurer Payment and Information Requirements |
| § 354.2343. Administrative Penalties for Failure to Provide Information |
| § 354.2344. Notice and Appeal of Administrative Penalty |
| DIVISION 6. BILLING AND PAYMENT GUIDELINES |
| § 354.2354. Billing Medicare Intermediaries |
| § 354.2355. Long Term Care Providers |
| § 354.2356. Provider Requirements to Bill Third Party Health Coverage |
| DIVISION 7. HEALTH INSURANCE PREMIUM PAYMENT GUIDELINES |
| § 354.2361. Medicaid Health Insurance Premium Payment Program |
| SUBCHAPTER K. MEDICAID RECIPIENT UTILIZATION REVIEW AND CONTROL |
| § 354.2401. Definitions |
| § 354.2403. Monitoring and Review |
| § 354.2405. Utilization Control |
| § 354.2407. Recipient Rights |
| SUBCHAPTER L. QUALITY IMPROVEMENT PROCESS FOR CLINICAL INITIATIVES |
| § 354.2501. Definitions |
| § 354.2503. Clinical Initiative Evaluation Process |
| § 354.2505. Action on Approved Clinical Initiatives |
| § 354.2507. Internet Website |
| SUBCHAPTER M. MENTAL HEALTH TARGETED CASE MANAGEMENT AND MENTAL HEALTH REHABILITATION |
| DIVISION 1. GENERAL PROVISIONS |
| § 354.2601. Purpose and Applicability |
| § 354.2603. Definitions |
| § 354.2605. Fair Hearings and Appeal Processes |
| § 354.2607. Assessment and Service Authorization |
| § 354.2609. Recovery/Treatment Planning, Recovery/Treatment Plan Review, and Discharge Summary |
| § 354.2611. Pharmacological Management, Psychiatric Diagnostic Evaluations, and Psychotherapy |
| § 354.2613. Criminal History Background Checks |
| DIVISION 2. MENTAL HEALTH TARGETED CASE MANAGEMENT |
| § 354.2651. Eligible Individuals |
| § 354.2653. Continued Eligibility |
| § 354.2655. Mental Health Targeted Case Management Services |
| § 354.2657. Documentation Requirements |
| § 354.2659. Exclusions |
| DIVISION 3. MENTAL HEALTH REHABILITATION |
| § 354.2701. Eligible Individuals |
| § 354.2703. Continued Eligibility |
| § 354.2705. Mental Health Rehabilitative Services |
| § 354.2707. Crisis Intervention Services |
| § 354.2709. Medication Training and Support Services |
| § 354.2711. Psychosocial Rehabilitative Services |
| § 354.2713. Skills Training and Development Services |
| § 354.2715. Day Programs for Acute Needs |
| § 354.2717. Exclusions |
| SUBCHAPTER N. PEER SPECIALIST SERVICES |
| DIVISION 1. GENERAL PROVISIONS |
| § 354.3001. Purpose and Applicability |
| § 354.3003. Definitions |
| DIVISION 2. SERVICE PROVISION |
| § 354.3011. Eligibility to Receive Services |
| § 354.3013. Services Provided |
| § 354.3015. Medicaid Reimbursement |
| DIVISION 3. PEER SPECIALISTS |
| § 354.3051. Minimum Qualifications |
| § 354.3053. Scope of Work |
| § 354.3055. Ethical Responsibilities |
| DIVISION 4. ORGANIZATIONS IN WHICH PEER SPECIALISTS DELIVER SERVICES |
| § 354.3101. Requirements |
| § 354.3103. Supervision of Peer Specialists |
| § 354.3105. Peer Specialist Supervisor Minimum Qualifications |
| DIVISION 5. TRAINING |
| § 354.3151. Training Entity Minimum Requirements |
| § 354.3153. Instructor Requirements |
| § 354.3155. Orientation and Self-Assessment |
| § 354.3157. Application for Training |
| § 354.3159. Core and Supplemental Training |
| § 354.3161. Peer Specialist Certification Renewal Training |
| § 354.3163. Supervisor Training |
| § 354.3165. Peer Specialist Supervisor Certification Renewal Training |
| DIVISION 6. PEER SPECIALIST AND PEER SPECIALIST SUPERVISOR CERTIFICATION |
| § 354.3201. Criminal History and Registry Checks |
| § 354.3203. Procedures for Peer Specialist Certification |
| § 354.3205. Initial Peer Specialist Certification |
| § 354.3207. Peer Specialist Certification Renewal |
| § 354.3209. Procedures for Peer Specialist Supervisor Certification |
| § 354.3211. Peer Specialist Supervisor Certification Renewal |
| DIVISION 7. CERTIFICATION ENTITIES |
| § 354.3251. Certification Entity Minimum Requirements |
| § 354.3253. Certification Entity Application Process |
| § 354.3255. Certification Entity Ongoing Requirements |
| DIVISION 8. COMPLAINTS, APPEALS, AND HEARINGS |
| § 354.3301. Recipient Complaints |
| § 354.3303. Peer Specialist or Peer Specialist Supervisor: Denial, Suspension, or Revocation of Certification or Renewal |
| § 354.3305. Training Entity: Denial, Suspension, or Revocation of Certification |
| § 354.3307. Certification Entity: Denial, Suspension, or Revocation of Approval |
| SUBCHAPTER O. ELECTRONIC VISIT VERIFICATION |
| § 354.4001. Purpose and Authority |
| § 354.4003. Definitions |
| § 354.4005. Personal Care Services that Require the Use of EVV |
| § 354.4006. Home Health Care Services that Require the Use of EVV |
| § 354.4007. EVV System |
| § 354.4009. EVV Visit Transaction and EVV Claim |
| § 354.4011. Visit Maintenance |
| § 354.4013. HHSC and MCO Compliance Reviews and Enforcement Actions |
| § 354.4015. EVV Training Requirements |
| § 354.4017. Process to Request Approval of a Proposed EVV Proprietary System and Additional Requirements for a PSO |
| § 354.4019. Access to EVV System and EVV Documentation |
| § 354.4021. Additional Requirements |
| § 354.4023. Sanctions |
| § 354.4025. Administrative Hearing |
| SUBCHAPTER P. AUTISM SERVICES |
| DIVISION 1. GENERAL PROVISIONS |
| § 354.5001. Purpose and Applicability |
| § 354.5003. Definitions |
| DIVISION 2. SERVICE PROVIDERS |
| § 354.5011. Providers of Applied Behavior Analysis (ABA) Services |
| DIVISION 3. PARAMETERS FOR SERVICE PROVISION |
| § 354.5021. Service Description, Requirements, and Limitations for Providing Applied Behavior Analysis (ABA) Services |
| § 354.5023. Additional Medicaid Reimbursement Limitations and Exclusions Specific to Applied Behavior Analysis (ABA) Services |