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10.4 Reimbursement
ACDs may be reimbursed at the lower of the billed amount or the amount allowed by the Centers for Medicare & Medicaid Services (CMS), when available, or Texas Medicaid. The reimbursement rates for the purchase or rental of ACDs are as follows:
• Purchase: The CSHCN Services Program may reimburse the lower of the billed amount or the manufacturer's suggested retail price (MSRP) less 15 percent for ACD purchases.
•Rental: The CSHCN Services Program may reimburse the lower of the billed amount or a maximum of $350 per month. Requests for rentals exceeding $350 per month must be submitted to the TMHP-CSHCN Services Program for review.
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