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3.2 Services, Benefits, Limitations, and Prior Authorization
3.2.1 Home Health Services
The benefit period for home health professional services is up to 60 days with a current plan of care (POC). This extended prior authorization period begins on the date that clients receive their first prior authorized home health service. Texas Medicaid allows additional visits that have been determined to be medically necessary and have been prior authorized by TMHP Home Health Services Prior Authorization Department. These records and claims must be retained for a minimum of five years from the date of service (DOS) or until audit questions, appeals, hearings, investigations, or court cases are resolved. Use of these services is subject to retrospective review.
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