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Texas Medicaid Reimbursement
2.1 Payment Information 2-2
2.2 Reimbursement Methodology 2-2
2.2.1 Fee Schedules 2-2
2.2.1.1 Physician Services in Outpatient Hospital Setting 2-3
2.2.1.2 Drugs/Biologicals 2-4
2.2.2 Cost Reimbursement 2-4
2.2.3 Reasonable Cost/Interim Rates 2-4
2.2.4 Hospitals 2-4
2.2.5 Provider-Specific Visit Rates 2-4
2.2.6 Manual Pricing 2-4
2.3 Professional Providers and Outpatient Facilities Reimbursement Reduction 2-5
2.4 Additional Payments to High-Volume Providers 2-5
2.5 Out-of-State Medicaid Providers 2-5
2.6 Medicare Crossover Reimbursement 2-6
2.6.1 Part A 2-6
2.6.2 Part B 2-6
2.7 Federal Financial Participation (FFP) Rate 2-6
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