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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 : 3.5 * Home Health SN and HHA Procedure Billing and Limitations : 3.5.2 Medication Administration Limitations

3.5.2
Nursing visits for the purpose of administering medications are not a benefit if one of the following conditions exists:
The medication is not considered medically necessary to the treatment of the individual’s illness or is not approved by the Food and Drug Administration (FDA) or is being used for indications not approved by the FDA.
The client, a primary caregiver, a family member, or neighbor have been taught or can be taught to administer subcutaneous (SQ/SC), intramuscular (IM), and intravenous (IV) injections and has demonstrated competency.

Texas Medicaid & Healthcare Partnership
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