SECTION 355.748. Reimbursement Methodology for Preadmission Screening and Resident Review (PASRR) Level II Evaluations

(a) Qualified providers. Payments are made to qualified providers delivering a Level II evaluation to determine if a person believed to have a mental illness (MI) or an intellectual or developmental disability (IDD) requires the level of care provided by a nursing facility (NF) and, if so, whether the person needs specialized services for their MI or IDD according to the program rules as defined in 40 TAC Chapter 17 (relating to Preadmission Screening and Resident Review).

(b) Unit of service. Qualified providers are reimbursed based on a 15-minute unit of service for a PASRR Level II evaluation.

(c) Reimbursement methodology.

(1) The Health and Human Services Commission determines the PASRR Level II evaluation rate based on the salary cost for a qualified provider and other statistical data on providers delivering similar services.

(2) The reimbursement methodology for a PASRR Level II evaluation is also governed by: §355.108 of this chapter (relating to Determination of Inflation Indices); §355.109 of this chapter (relating to Adjusting Reimbursement When New Legislation, Regulations, or Economic Factors Affect Costs); and §355.110 of this chapter (relating to Informal Reviews and Formal Appeals).

Source Note: The provisions of this §355.748 adopted to be effective May 24, 2013, 38 TexReg 2976