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December 2016 Texas Medicaid Provider Procedures Manual

Section 2: Texas Medicaid Fee‑for‑Service Reimbursement : 2.2 Fee-for-Service Reimbursement Methodology : 2.2.3 Reasonable Cost and Interim Rates

Outpatient hospital services are reimbursed in accordance with 1 TAC §355.8061. The reimbursement methodology is based on reasonable costs, and providers are reimbursed at an interim rate based on the provider’s most recent Medicaid cost report settlement. To determine the provider’s payable amount, the interim rate is applied to the claim details allowed amount.

Texas Medicaid & Healthcare Partnership
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