Tex. Gov't Code Section 545.0203
Reimbursement Claims for Certain Medicaid or Child Health Plan Services Involving Supervised Providers

(a)

In this section, “national provider identifier” means the national provider identifier required under Section 1128J(e), Social Security Act (42 U.S.C. Section 1320a-7k(e)).

(b)

If a Medicaid or child health plan program provider, including a nurse practitioner or physician assistant, provides a referral or orders health care services for a Medicaid recipient or child health plan program enrollee at the direction or under the supervision of another provider and the referral or order is based on the supervised provider’s evaluation of the recipient or enrollee, the names and associated national provider identifier numbers of the supervised provider and the supervising provider must be included on any claim for reimbursement a provider submits based on the referral or order.

(c)

The executive commissioner shall adopt rules necessary to implement this section.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.

Source: Section 545.0203 — Reimbursement Claims for Certain Medicaid or Child Health Plan Services Involving Supervised Providers, https://statutes.­capitol.­texas.­gov/Docs/GV/htm/GV.­545.­htm#545.­0203 (accessed May 18, 2024).

545.0001
Definitions 545.0002
Development and Implementation of Integration Plan 545.0003
Methods to Address Fraud and Eligibility Error Rate 545.0004
Contract for Integration Plan Implementation 545.0005
Use of Other Agencies’ Staff and Resources 545.0006
Funding 545.0051
Consolidated Recipient Identification and Benefits Issuance Method 545.0052
Expansion of Billing Coordination and Information Collection Activities 545.0053
Service Delivery Area Alignment 545.0054
Program to Improve and Monitor Certain Outcomes of Medicaid Recipients and Child Health Plan Program Enrollees 545.0055
Minimum Collection Goal for Recovery of Certain Benefits 545.0056
Distribution of Earned Income Tax Credit Information 545.0057
Application Assistance for Financial Assistance Recipients Eligible for Federal Programs 545.0101
Memorandum of Understanding Regarding Medicaid and Child Health Plan Program Eligibility Determinations for Certain Children 545.0102
Verification of Immigration Status of Certain Applicants for Public Assistance Benefits 545.0103
Verification of Sponsorship Information for Certain Benefits Recipients or Enrollees 545.0104
Call Centers 545.0151
Definition 545.0152
Electronic Recording of Hearing 545.0153
Administrative Review 545.0154
Judicial Review 545.0201
Compliance with Solicitation Prohibitions 545.0202
Marketing Activities by Medicaid or Child Health Plan Program Providers 545.0203
Reimbursement Claims for Certain Medicaid or Child Health Plan Services Involving Supervised Providers 545.0204
Participation of Diagnostic Laboratory Service Providers in Certain Programs
Green check means up to date. Up to date

Accessed:
May 18, 2024

§ 545.0203’s source at texas​.gov