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December 2016 Texas Medicaid Provider Procedures Manual

Home Health Nursing and Private Duty Nursing Services Handbook : 3 Home Health Skilled Nursing and Home Health Aide Services : 3.1 * Services, Benefits, Limitations, and Prior Authorization : 3.1.1 Medical Necessity

3.1.1
SN and HHA visits are considered medically necessary for a client who:
Note:
When documentation does not support medical necessity for home health SN or HHA visits, providers may be directed to possible alternative services based on the client’s age and needs.

Texas Medicaid & Healthcare Partnership
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