DADS released one provider and three information letters:
HCSSAs: All Medicare-approved home health agencies or those seeking approval under Medicare must comply with Outcome and Assessment Information Set (OASIS)-C requirements. Download the patient classification table here and the letter here.
HCS, TxHmL, and CDSAs: HHSC approved new payment rates for these programs, effective September 1, available at the HHSC Rate Analysis web page and TxHmL web page. Download the letter for additional links.
CDSAs, HCS, and TxHmL: DADS provided guidance to these programs for revising CDS employer budgets and for filing claims as a result of CARE system changes implemented for rate increases in the HCS and TxHmL programs. (Letter)
Hospice Providers: DADS notified hospice providers that they can bill for ventilator services provided to residents in nursing facilities. (Letter):
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Service Code 4 = Ventilator Services
Bill Code – N0500
Partial Ventilator Services = CPT Code 94567
Revenue Code = 0659
Bill Code – N0501
Full Ventilator Services = CPT Code 94004
Revenue Code = 0659
Reimbursement Rates
August 1, 2009 = Full Ventilator Services = $116.28
August 1, 2009 = Partial Ventilator Services = $46.51
September 1, 2009 and forward = Full Ventilator Services = $118.84
September 1, 2009 and forward = Partial Ventilator Services = $47.54
