MDCP Electronic Billing and Claims

Electronic Billing

There is no cost for the software. To request electronic billing, please contact the Texas Medicaid & Healthcare Partnership (TMHP).

Adaptive Aid Providers

Vehicle lifts with tie-downs; other items not covered by other sources; assessment, training and installation related to adaptive aids provided by Medicaid-enrolled providers of durable medical equipment and supplies; or providers approved by Texas Health and Human Services (HHS) for vehicle lifts.

  • The Adaptive Aid service limit is $4,000.
  • Participant's family is responsible for adaptive aids costing less than $100.
  • 3bids are required for adaptive aids costing over $100. HHS will authorize the amount of the lowest bid for the approved adaptive aid.

Minor Home Modification Providers

Ramps, doorway widening, bathroom modifications provided by licensed general contractors.

  • The minor home modification lifetime service limit maximum is $7,500. Reimbursement will be based on the lowest of the comparable and responsible bids submitted for the approved modification.

Repair or replacement of approved modifications when not covered by warranty provided by licensed general contractors

  • Maximum annual allotment of $300 for repair and replacement, not included in $7,500 lifetime allotment.

Respite/Adjunct Support Provider Categories and Types

In-home Providers

  • Independently enrolled qualified licensed vocational nurses (LVN)
  • Independently enrolled registered nurses (RN)
  • RN employed by a home and community support services agency (HCSSA)
  • LVN employed by the HCSSA
  • An attendant employed by the HCSSA with delegation by an RN
  • An attendant employed by the HCSSA without delegation by an RN

Facility-based Providers

The following providers will be reimbursed an amount equal to the MDCP participant's daily Resource Utilization Group (RUG) rate, prorated for the number of hours of respite provided.

  • Licensed nursing facilities
  • Hospitals


Licensed/accredited camps.

Payment rates for MDCP providers can be found on the Texas Health and Human Services Commission's rate analysis website.