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2012 Texas Medicaid Provider Procedures Manual

Volume 1, General Information : Section 4: Client Eligibility : 4.15 Long-Term Care Providers

4.15 Long-Term Care Providers
A nursing facility, home health services provider, or any other similar long-term care services provider that is Medicare-certified must:
Seek reimbursement from Medicare before billing Texas Medicaid for services provided to an individual who is eligible to receive similar services under the Medicare program.
A nursing facility, home health services provider, or any other similar long-term care services provider that is Medicare-certified is not required to seek reimbursement from Medicare before billing Texas Medicaid for a person who is Medicare-eligible and has been determined to not be homebound.

Texas Medicaid & Healthcare Partnership
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