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December 2016 Texas Medicaid Provider Procedures Manual

Section 2: Texas Medicaid Fee‑for‑Service Reimbursement : 2.5 Additional Payments to High-Volume Providers

2.5
High volume provider payments are made to outpatient hospitals per1 TAC §355.8061 and ASCs/HASCs per 1 TAC §355.8121.
Outpatient hospital services are those services provided by outpatient hospitals and ASCs/HASCs. The definition of a high-volume outpatient hospital provider is one that was paid a minimum of $200,000 during the qualifying period.
The reimbursement rate for non-high-volume hospitals is as follows with the application of the hospital specific interim rate:
 
The reimbursement rate for high-volume hospitals is as follows with the application of the hospital specific interim rate:
 

Texas Medicaid & Healthcare Partnership
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