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December 2016 Texas Medicaid Provider Procedures Manual

Certified Respiratory Care Practitioner (CRCP) Services Handbook : 6 * Prescribed Pediatric Extended Care Center (PPECC) Services

6
CRCP services may be reimbursed when provided in a PPECC setting. When services are rendered in a PPECC setting, the PPECC’s name and NPI number must appear on the professional claim, in addition to the certified respiratory care provider’s NPI. The certified respiratory care practitioner must also indicate outpatient hospital as the place of service when rendering services in a PPECC, or the claim will be denied.
When certified respiratory care services are rendered in a PPECC, the certified respiratory care provider must document coordination with the PPECC.
The PPECC and the certified respiratory care practitioner must have a written agreement for each client related to the provision of respiratory care practitioner services provided at the PPECC. The written agreement must address responsibilities of both parties, and how the parties will coordinate related to the client’s plan of care. The written agreement must be maintained in the client’s medical record.

Texas Medicaid & Healthcare Partnership
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