Claims (Provider Claims Hotline)
- Nursing facility/hospice billing: 512-438-2200, Option 1
- Emergency dental, rehab/specialized services: 512-438-2200, Option 6
Nursing facility inquiries related to culture change principles, philosophy or practice (e.g. person-directed care, related regulations, home-like environment):
Long-term Care Regulatory Nursing Facility, Policy or Rule Questions
- firstname.lastname@example.org or 512-438-3161.
How to Become a Nursing Facility Provider
In order to become a nursing facility provider, you must first apply for a license. Facilities may wish to be private pay (facility with no certification) or Medicaid - and/or Medicare-certified. To contact provider licensure and certification, call 512-438-2630.
How to Obtain a Medicaid Contract
To contact Contract Administration and Provider Monitoring call 512-438-3390 or email at CAPM_NF_ICF_Contracts@hhsc.state.tx.us.
Minimum Data Set (MDS) Resources
- MDS Automation Coordinator, Brian Johnson, 512-438-2396
- MDS RAI Coordinator, Susan Edgeman, 210-431-5106
- MDS website
Preadmission Screening and Resident Review (PASRR)
- Customized Manual Wheelchair and Durable Medical Equipment benefits (specialized services only).
Quality Monitoring Program (QMP)
- Director, Michelle Dionne-Vahalik
- Dietitian and Pharmacist Program Manager, Ivette Rivera-Ortiz
- Nurse Program Manager, Debbie Kane
- Regional Nurse Managers
- QMP Website
- Phone number: 512-438-4399
Long-term Care Regulatory Regional Contacts
RUG Training Information
- 512-491-2072, 512-491-1750, 512-491-2020