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TITLE 1 - ADMINISTRATION
PART 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 355 - REIMBURSEMENT RATES
SUBCHAPTER J - PURCHASED HEALTH SERVICES
SECTION/RULE §355.8641 - Reimbursement Methodology for the Women's Health Program
Chapter Review Date 08/06/2024

(a) Services provided through the Women's Health Program (WHP) will be reimbursed on a fee-for-service basis in accordance with §355.8581 of this chapter (relating to Reimbursement Methodology for Family Planning Services).(b) If a service provided through WHP is not addressed in §355.8581 of this chapter, it will be reimbursed as follows:(1) For physician services, physician-administered drugs and biologicals, and the administration of immunizations, a provider is reimbursed the lesser of:(A) the provider's billed charges; or(B) fees determined by the Texas Health and Human Services Commission (HHSC) in accordance with §355.8085 of this chapter (relating to Reimbursement Methodology for Physicians and Other Practitioners).(2) HHSC reimburses all other covered services in accordance with the reimbursement rules in this chapter.

Source Note: The provisions of this §355.8641 adopted to be effective November 1, 2012, 37 TexReg 8199.

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