Primary Home Care (PHC)

What is PHC?

Primary Home Care is a nontechnical, medically related personal care service that is available to eligible individuals whose health problems cause them to have limitations in performing activities of daily living, according to a practitioner's statement of medical need. PHC personal care tasks are provided by an attendant.

Provider Communications

Click here for news, information letters (ILs) & provider letters (PLs).

Contact Program Staff

For questions about:

Contracting to Provide Services

PHC providers must be licensed as a Home and Community Support Services Agency (HCSSA) within the category of Licensed Home Health Services, Licensed and Certified Home Health Services, or Personal Assistance Services and have a contract with HHSC to provide PHC services. Rules regarding minimum standards for HCSSA licensure can be found in Title 26 Chapter 558 of the Texas Administrative Code.

For more information about HHSC contracting requirements, please click here..

To be eligible to provide PHC and receive reimbursement, a provider agency must meet certain eligibility criteria. Rules regarding minimum eligibility requirements for contracting can be found in Title 40 of the Texas Administrative Code as follows:

PHC is one of three separate programs under one contract. The other two programs are Community Attendant Services and Family Care. A PHC/FC/CAS contractor must agree to serve individuals in each program.

Learn more information about HHSC provider enrollment process and requirements.

An individual or provider agency must complete an application to provide services in the Community Services programs. To ensure all required documents are submitted with your application, review the application checklist for this program using

Contract applicants and current contractors for PHC/FC/CAS may submit contract applications, completed forms and required information by:

Regular Mail
Texas Health and Human Services Commission
Eligibility Operations Provider Contract Management Mail Code W-357
P.O. Box 149030
Austin, Texas 78714-9030

Overnight/Express Delivery
Texas Health and Human Services Commission
Eligibility Operations Provider Contract Management
Mail Code W-357
909 West 45th Street
Austin, Texas 78751

Should you have any questions regarding the enrollment process for these programs, contact Eligibility Operations Provider Contract Management at 512-438-3550.

In accordance with 40 Texas Administrative Code Section 49.302(b), HHSC requires a newly enrolled PHC/FC/CAS contractor to either successfully complete program orientation or to submit verification that the program orientation was completed in another region for the same contract type before HHSC places the contract of the contractor on the regional choice list. After HHSC awards the contract, Regional Enrollment and Monitoring staff will contact the contractor to schedule the program orientation.

Statutes & Rules

State

Federal

Other Rules and Statutes

Subscribe to HHS Emails

HHSC contracts with a company called Granicus to provide email updates, called GovDelivery. In accordance with your contract, and contracting rules at 40 Texas Administrative Code Section 49.302(g), you must subscribe to receive HHSC email updates via GovDelivery.

Communications

Information & Provider Letters

Case-sensitive. Use commas to separate multiple entries.
Note: These files are in PDF format unless otherwise noted.
Number Title/Notes Date Published
IL 2014-83.2 2014 Cost Report Training Information
IL 2014-77 STAR+PLUS Managed Care Resource Information for Transitioned Community Based Alternatives, Primary Home Care and Day Activity Health Services Providers
IL 2014-74 Contract and Fiscal Compliance Monitoring Updated Negative Billing Procedures

Note: Replaces IL 13-28

IL 2014-55 Payment Rates Effective September 1, 2014
IL 2014-49 Billing Process for Long-Term Services and Supports Providers Transitioning to STAR+PLUS
IL 2014-41 Expansion of Medicaid Acute Care Services – Provision of Day Activity and Health Services and Primary Home Care for Individuals in Intellectual and Developmental Disabilities Waivers
IL 2014-35 Electronic Visit Verification Liquidated Damages
IL 2014-31 Applying for Primary Home Care and Day Activity Health Services Pending STAR+PLUS Enrollment
IL 2014-23 Expansion of the STAR+PLUS Medicaid Managed Care Program to the Medicaid Rural Service Areas
IL 2014-22 Preparing for the Upcoming Fiscal Year 2014 Claims Billing Closeout