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25.3.3.3 Outpatient Total Parenteral Nutrition/Hyperalimentation
Outpatient total parenteral nutrition (TPN)/hyperalimentation is a benefit of the Texas Medicaid Program for eligible clients who require long-term nutritional support because of extensive bowel resection and/or severe advanced bowel disease in which the bowel cannot absorb nutrition.
Covered services must be medically necessary and prescribed by the physician. This service is not payable when oral/enteral intake will maintain adequate nutrition. TPN/hyperalimentation and lipids must be prior authorized.
Outpatient hospital TPN/hyperalimentation should be billed using the appropriate revenue code. Reimbursement to hospital outpatient departments furnishing in-home TPN services may not exceed the maximum yearly fee established by HHSC or its designee. Claims for TPN/hyperalimentation therapy administered as a nutritional supplement are denied.
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