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December 2016 Texas Medicaid Provider Procedures Manual

Inpatient and Outpatient Hospital Services Handbook : 3 Inpatient Hospital (Medical/Surgical Acute Care Inpatient Facility) : 3.3 Services, Benefits, Limitations, and Prior Authorization - Inpatient Rehabilitation Services

3.3
Inpatient rehabilitation services are a benefit of Texas Medicaid when provided as part of a general acute care inpatient admission, or with prior authorization for clients who are 20 years of age and younger in a freestanding rehabilitation facility.
Inpatient rehabilitation services in an acute care setting are included in the hospital DRG payment. All rehabilitation services are subject to Medicaid benefit limitations including the spell of illness. Exceptions to those limitations may be offered under CCP.
Refer to:
Section 1.6.15, “Physical, Occupational, and Speech Therapy Providers” in “Section 1: Provider Enrollment and Responsibilities” (Vol. 1, General Information).
Subsection 2.17, “Inpatient Rehabilitation Facility (Freestanding) (CCP),” in the Children’s Services Handbook (Vol. 2, Provider Handbooks).

Texas Medicaid & Healthcare Partnership
CPT only copyright 2014 American Medical Association. All rights reserved.