SECTION 355.310. Reimbursement Methodology for Customized Equipment

(a) Reimbursement rates for customized power wheelchairs (CPWCs) and associated physical or occupational therapy evaluations provided under 40 TAC §19.2614 (relating to Customized Power Wheelchairs) are determined as follows:

(1) For CPWCs, rates are determined in accordance with §355.8023 of this title (relating to Reimbursement Methodology for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS)).

(2) For evaluations required for CPWCs under 40 TAC §19.2614(c), rates are determined in accordance with §355.313 of this title (relating to Reimbursement Methodology for Rehabilitative and Specialized Services).

(b) Reimbursement rates for customized adaptive aids and associated physical or occupational therapy evaluations provided under 40 TAC Chapter 17 (relating to Preadmission Screening and Resident Review) are determined as follows:

(1) For customized adaptive aids, rates are determined in accordance with §355.8023 of this title.

(2) For evaluations required for customized adaptive aids, rates are determined in accordance with §355.313 of this title.

(c) Fees for customized equipment are adjusted within available funding as described in §355.201 of this title (relating to Establishment and Adjustment of Reimbursement Rates by the Health and Human Services Commission).

Source Note: The provisions of this §355.310 adopted to be effective May 8, 2008, 33 TexReg 3569; amended to be effective May 24, 2013, 38 TexReg 2976; amended to be effective December 1, 2017, 42 TexReg 5431