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24.4 Home Health Services
The benefit period for home health professional services is up to 60 days with a current POC. In chronic and stable situations, DME and supplies ordered on a Home Health Services (Title XIX) Durable Medical Equipment (DME)/Medical Supplies Physician Order Form may be authorized for up to six months with medical necessity determination. Because a Medicaid client's eligibility period is for one month, providers should bill for a one month supply at a time, even though prior authorization may be granted for up to six months. This extended authorization period begins on the date that clients receive their first authorized home health service. The Texas Medicaid Program allows additional visits, DME, or supplies that have been determined to be medically necessary and have been authorized by TMHP Home Health Services Authorization Department. Providers must retain all orders, signed and dated Title XIX forms, delivery slips, and invoices for all supplies provided to a client and must disclose them to the HHSC or its designee on request. 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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