TX · guidance
Tex. HHSC Medicaid Hospice Provider Manual § 1200
Participation in Medicaid and/or Medicare
Revision 08-1; Effective November 12, 2008
Medicare
The Texas Health and Human Services Commission (HHSC) Home and Community Support Services Agencies (HCSSA) section is responsible for the state licensure and for the Centers for Medicare and Medicaid Services Medicare certification of hospice agencies. HHSC uses federal Medicare hospice regulations as the basis for Texas hospice licensure and certification and for subsequent annual surveys. Home health agencies with a hospice service designation, and any agency/facility that calls itself a hospice that is not fully licensed and Medicare certified as a hospice agency, are not eligible to participate in the Medicaid Hospice Program.
Dually Certified
Dually certified providers participate in both the Medicaid and Medicare Hospice Programs. Dually certified providers must be certified under both programs and adhere to both Medicare and Medicaid requirements. Providers must be licensed and Medicare certified to become a Medicaid provider.
Medicaid hospice is an optional benefit as outlined under the Social Security Act, §1902 (a)(10)(A)(i)-(vii). HHSC Community Services Contracts is responsible for Medicaid contracting. A provider agency must follow rules and guidelines that comply with all applicable state and local laws. Providers are responsible for becoming familiar with the following regulations and guidelines:
State Operations Manual, Chapter 2, Section 2082, Election of Hospice Benefit by Resident of SNF, NF, ICF/MR or Non-certified Facility
State Medicaid Manual, Section 4305, Hospice Services
42 Code of Federal Regulations, Chapter 418, Hospice Care
40 Texas Administrative Code (TAC), Chapter 49, Contracting for Community Care Services
40 TAC, Chapter 30, Medicaid Hospice Program
40 TAC, Chapter 97, Home and Community Support Service Agencies
1 TAC, Chapter 371, Subchapter C, Utilization Review, §371.212 and §371.214.
In addition, the following provider rules address hospice services:
40 TAC, Chapter 19, §19.1926 Medicaid Hospice
40 TAC, Chapter 9, Subchapter E, Division 9, §274 Hospice Services.
All state rules can be accessed at: www.sos.state.tx.us/tac/index.shtml.
Provenance
- Source
- fhb.hhs.texas.gov
- Retrieved
- 2026-10-01
- Edition
- mhpm-2011-05-11
- Content hash
0e32d688e3c0fd24faa2ff93679ebab8660ce69a10021cc3329b3eaf574814a3
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