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December 2016 Texas Medicaid Provider Procedures Manual

Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook : 2 Texas Medicaid (Title XIX) Home Health Services : 2.2 Services, Benefits, Limitations and Prior Authorization : 2.2.5 Bath and Bathroom Equipment : Prior Authorization
Except as otherwise indicated in this section, prior authorization is required for all bath and bathroom equipment and related supplies, including any accessories, modifications, adjustments, replacements and repairs to the equipment. The bath and bathroom equipment must be able to accommodate a 20 percent change in the client’s height or weight.
Bathroom and toilet lift rentals may be prior authorized during the period of repair up to a maximum of four months per lifetime per client.
Prior authorization will not be considered for modifications, adjustments, or repairs to bath or bathroom equipment delivered to a client’s home and then found to be inappropriate for the client’s condition within the first six months after delivery. This applies unless there is a significant change in the client’s condition that is documented by a physician familiar with the client.

Texas Medicaid & Healthcare Partnership
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