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December 2016 Texas Medicaid Provider Procedures Manual

Behavioral Health, Rehabilitation, and Case Management Services Handbook : 6 Physician, Psychologist, and Licensed Psychological Associate (LPA) Providers : 6.6 Court-Ordered and DFPS-Directed Services : 6.6.2 Documentation Requirements

6.6.2
If the client requires more than four hours of psychological or neuropsychological testing per day or more than eight hours of psychological or neuropsychological testing per calendar year, additional documentation is required to support the medical necessity for the additional hours. Additional psychological or neuropsychological testing hours may be considered when supported by a court-order or DFPS-direction, or as an exception on a case-by-case basis. All documentation must be maintained by the provider in the client’s record.
For court-ordered admissions, a copy of the doctor’s certificate and all court-ordered commitment papers signed by the judge must be submitted with the Psychiatric Inpatient Extended Stay Request Form.
Specific court-ordered services for evaluations, psychological or neuropsychological testing, or treatment may be prior authorized as mandated by the court. Prior authorization requests must be accompanied by a copy of the court document signed by the judge. If the requested services differ from or go beyond the court order, the additional services will be reviewed for medical necessity.
Specific DFPS-directed services for evaluations, psychological or neuropsychological testing, or treatment may be prior authorized as directed. Prior authorization requests must be accompanied by a copy of the directive or summary signed by the DFPS employee. If the requested services differ from the DFPS direction, the additional services will be reviewed for medical necessity. Requested services beyond those directed by DFPS are subject to medical necessity review.

Texas Medicaid & Healthcare Partnership
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