January 14, 2019 - 1:30pm

Health and Human Services Commission, Brown-Heatly Building Public Hearing Room
4900 North Lamar Boulevard
Austin, TX 78751

Webcasting Available

Entry is through security at the main entrance of the building facing Lamar Blvd.

Hearing. The Texas Health and Human Services Commission (HHSC) will conduct a public hearing to receive public comment on proposed Medicaid payment rates for the 2019 Annual Healthcare Common Procedure Coding System (HCPCS) Updates.

The public hearing will be held in HHSC's Public Hearing Room at the Brown-Heatly Building, located at 4900 North Lamar Boulevard, Austin, Texas. Entry is through security at the main entrance of the building, which faces Lamar Boulevard. HHSC will broadcast the public hearing; the broadcast can be accessed at https://hhs.texas.gov/about-hhs/communications-events/live-archived-meetings. The broadcast will be archived and can be accessed on demand at the same website. The public hearing will be held in compliance with Texas Human Resources Code §32.0282, which requires public notice of and hearings on proposed Medicaid reimbursements.

Proposal. The payment rates for the 2019 Annual HCPCS Updates are proposed to be effective January 1, 2019, for the following services:

Physician Administered Drugs – Type of Service (TOS) 1 (Medical Services), TOS S (THSteps Medical);

Medical Services – TOS 1 (Medical Services);

Surgery and Assistant Surgery Services – TOS 2 (Surgery Services) and TOS 8 (Assistant Surgery);

Radiological Services – TOS 4 (Radiology), TOS I (Professional Component), and TOS T (Technical Component);

Nonclinical Laboratory Services – TOS 5 (Laboratory), TOS I (Professional Component), and TOS T (Technical Component);

Clinical Laboratory Services – TOS 5 (Laboratory Services);

Anesthesia Services –TOS 7 (Anesthesia Services);

Durable Medical Equipment, Prosthetics, Orthotics, and Supplies – TOS 9 (Other Medical Items or Services), TOS J (DME Purchase - New), TOS L (DME Rental – Monthly);

Ambulatory Surgical Center – TOS F (Ambulatory Surgical Center);

Audiology – TOS R (Hearing Aid); and

Dental Services – TOS W (Texas Health Steps Dental/Orthodontia).

Methodology and Justification. The proposed payment rates were calculated in accordance with Title 1 of the Texas Administrative Code:

§355.8021, which addresses the reimbursement methodology for home health services;

§355.8023, which addresses the reimbursement methodology durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS);

§355.8085, which addresses the reimbursement methodology for physicians and other practitioners;

§355.8097, which addresses the reimbursement methodology for physical, occupational, and speech therapy services;

§355.8121, which addresses the reimbursement methodology for ambulatory surgical centers;

§355.8141, which addresses the reimbursement methodology for hearing aid services;

§355.8221, which addresses the reimbursement methodology for certified registered nurse anesthetists and anesthesiology assistants;

§355.8441, which addresses the reimbursement methodologies for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services (also known as Texas Health Steps) and the THSteps Comprehensive Care Program (CCP); and

§355.8610, which addresses the reimbursement methodology for clinical laboratory services.

Briefing Package. A briefing package describing the proposed payment rates will be available at http://rad.hhs.texas.gov/rate-packets on or after December 20, 2018. Interested parties may obtain a copy of the briefing package prior to the hearing by contacting Rate Analysis by telephone at (512) 730-7401; by fax at (512) 730-7475; or by e-mail at RADAcuteCare@hhsc.state.tx.us. The briefing package will also be available at the public hearing.

Written Comments. Written comments regarding the proposed payment rates may be submitted in lieu of, or in addition to, oral testimony until 5 p.m. the day of the hearing. Written comments may be sent by U.S. mail, overnight mail, special delivery mail, hand delivery, fax, or e-mail:

U.S. Mail
Texas Health and Human Services Commission
Attention: Rate Analysis, Mail Code H-400
P.O. Box 149030
Austin, Texas 78714-9030

Overnight mail, special delivery mail, or hand delivery
Texas Health and Human Services Commission
Attention: Rate Analysis, Mail Code H-400
Brown-Heatly Building
4900 North Lamar Blvd.
Austin, Texas 78751

Phone number for package delivery: (512) 730-7401

Fax
Attention: Rate Analysis at (512) 730-7475

E-mail
RADAcuteCare@hhsc.state.tx.us

Persons with disabilities who wish to attend the hearing and require auxiliary aids or services should contact Rate Analysis at (512) 730-7401 at least 72 hours in advance so appropriate arrangements can be made.