Tex. Gov't Code Section 548.0256
Reimbursement for Other Conditions and Risk Factors

(a)

To comply with state and federal requirements to provide access to medically necessary services under the Medicaid managed care program, a Medicaid managed care organization may reimburse providers for home telemonitoring services provided to individuals who have conditions and exhibit risk factors other than those expressly authorized by this subchapter.

(b)

In determining whether the Medicaid managed care organization should provide reimbursement for services under this section, the organization shall consider whether reimbursement for the service is cost-effective and providing the service is clinically effective.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.

Source: Section 548.0256 — Reimbursement for Other Conditions and Risk Factors, https://statutes.­capitol.­texas.­gov/Docs/GV/htm/GV.­548.­htm#548.­0256 (accessed Jun. 5, 2024).

548.0001
Provision of Services Through Telecommunications and Information Technology Under Medicaid and Other Public Benefits Programs 548.0002
Rules and Procedures Regarding Reimbursing Certain Telemedicine Medical Services 548.0051
Medicaid Reimbursement System for Telemedicine Medical, Teledentistry Dental, and Telehealth Services 548.0052
Reimbursement for Telemedicine Medical, Teledentistry Dental, or Telehealth Service by Medicaid Managed Care Organization 548.0053
Reimbursement of Federally Qualified Health Centers for Telemedicine Medical, Teledentistry Dental, or Telehealth Service 548.0054
Provider and Facility Participation 548.0055
Promotion and Support of Medical Home and Care Coordination 548.0056
Biennial Report 548.0057
Rules 548.0101
Definitions 548.0102
Medicaid Reimbursement Requirements: Telemedicine Medical Services 548.0103
Physician’s Choice of Platform 548.0104
Certain Telemedicine Medical Service Reimbursement Denials Prohibited 548.0105
Protocols and Guidelines 548.0106
Provider Coordination 548.0107
Compliance 548.0108
Texas Medical Board Rules 548.0109
Effect on Other Requirements 548.0151
Medicaid Reimbursement Requirements 548.0152
Dentist’s Choice of Platform 548.0153
Certain Teledentistry Dental Services Reimbursement Denials Prohibited 548.0154
State Board of Dental Examiners Rules 548.0201
Reimbursement for Telemedicine Medical, Teledentistry Dental, and Telehealth Services Provided to Children with Special Health Care Needs 548.0202
Medicaid Reimbursement for Telemedicine Medical Services Provided in School-based Setting 548.0203
Medicaid Reimbursement for Telehealth Services Provided Through School District or Charter School 548.0251
Definitions 548.0252
Medicaid Reimbursement Program for Home Telemonitoring Services Authorized 548.0253
Reimbursement Program Requirements 548.0254
Discontinuation of Reimbursement Program Under Certain Circumstances 548.0255
Determination of Cost Savings for Medicare Program 548.0256
Reimbursement for Other Conditions and Risk Factors 548.0301
Definition 548.0302
Medicaid Reimbursement for Internet Medical Consultation Authorized 548.0303
Pilot Program for Medicaid Reimbursement for Internet Medical Consultation 548.0351
Definitions 548.0352
Establishment of Pediatric Tele-connectivity Resource Program for Rural Texas 548.0353
Use of Program Grant 548.0354
Selection of Program Grant Recipients 548.0355
Gifts, Grants, and Donations 548.0356
Work Group 548.0357
Biennial Report 548.0358
Rules 548.0359
Appropriation Required 548.0401
Telehealth Treatment Program for Substance Use Disorders
Green check means up to date. Up to date

Accessed:
Jun. 5, 2024

§ 548.0256’s source at texas​.gov