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Texas Medicaid Reimbursement
2.1 Reimbursement 2-2
2.1.1 Electronic Funds Transfer 2-2
2.1.1.2 Advantages of EFT 2-2
2.1.1.3 Enrollment Procedures 2-2
2.2 Reimbursement Methodology 2-2
2.2.1 Fee Schedules 2-3
2.2.1.1 Physician Services in Outpatient Hospital Setting 2-5
2.2.1.2 Drugs/Biologicals 2-5
2.2.2 Reasonable Cost/Interim Rates 2-5
2.2.3 Hospitals 2-6
2.2.4 Provider-Specific Visit Rates 2-6
2.2.5 Manual Pricing 2-6
2.3 Professional Providers and Outpatient Facilities Reimbursement Reduction 2-6
2.4 Additional Payments to High-Volume Providers 2-6
2.5 Medicaid Service Provided Outside Texas 2-6
2.6 Medicare Crossover Reimbursement 2-7
2.6.1 Part A 2-7
2.6.2 Part B 2-7
2.7 Federal Financial Participation (FFP) Rate 2-7
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