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TITLE 1 - ADMINISTRATION
PART 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 354 - MEDICAID HEALTH SERVICES
SUBCHAPTER A - PURCHASED HEALTH SERVICES
SECTION/RULE §354.1381 - Benefits and Limitations
Chapter Review Date 11/08/2024

(a) Counseling for emotional disorders or conditions provided by licensed professional counselors (LPCs), licensed clinical social workers (LCSWs), and licensed marriage and family therapists (LMFTs) as allowed by each respective licensing law are covered services.(b) To be considered payable, the services must be reasonable and medically necessary as determined by the Health and Human Services Commission or its designee.(c) LPCs, LCSWs, or LMFTs who are employed by or remunerated by another provider may not bill the Texas Medical Assistance Program directly for counseling services if that billing would result in duplicate payment for the same services.

Source Note: The provisions of this §354.1381 adopted to be effective February 14, 1995, 20 TexReg 568; amended to be effective April 1, 2000, 25 TexReg 2630; transferred effective September 1, 2001, as published in the Texas Register May 24, 2002, 27 TexReg 4561; amended to be effective September 1, 2003, 28 TexReg 7296; amended to be effective December 1, 2005, 30 TexReg 7850.

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