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TITLE 1 - ADMINISTRATION
PART 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 363 - TEXAS HEALTH STEPS COMPREHENSIVE CARE PROGRAM
SUBCHAPTER C - PRIVATE DUTY NURSING SERVICES
SECTION/RULE §363.307 - Medical Necessity
Chapter Review Date 04/17/2024

(a) PDN services are available to EPSDT-eligible recipients when the services are medically necessary to correct or ameliorate the recipient's disability or physical or mental illness or condition. The services correct or ameliorate when they improve, maintain, or slow the deterioration of the recipient's health status.(b) Medical necessity must be documented in the recipient's prior authorization request.

Source Note: The provisions of this §363.307 adopted to be effective October 15, 2015, 40 TexReg 7056.

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