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Texas Therapy Services Policy Manual

Texas Therapy Services Policy Manual

$4,199.00Price
ABOUT THIS POLICY MANUAL
 
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The Texas Therapy Services Policy Manual provides a comprehensive framework for delivering physical, occupational, speech-language, and other rehabilitative therapy services to individuals in Texas. This manual aligns with federal and state regulations, including Medicaid and Medicare Conditions of Participation (42 CFR Part 484), the Texas Administrative Code (§355.8091), and policies established by the Texas Health and Human Services Commission (HHSC). It ensures compliance with legal mandates to provide high-quality, medically necessary therapy services that promote recovery, independence, and improved functional outcomes.
The manual outlines policies and procedures for assessing client needs, developing individualized therapy plans, delivering services, and maintaining compliance with state licensure and certification requirements. It emphasizes evidence-based practices, interdisciplinary collaboration, and adherence to quality assurance measures.
Key areas covered in the manual include:
  • Eligibility and Enrollment: Guidelines for determining eligibility for therapy services under Medicaid waiver programs such as STAR+PLUS or private insurance plans. Eligibility criteria include medical necessity for rehabilitative therapies to address functional limitations or developmental delays.
  • Service Delivery Standards: Policies for providing therapy services such as physical therapy (PT) to improve mobility and strength, occupational therapy (OT) to enhance daily living skills, speech-language pathology (SLP) to address communication or swallowing disorders, and other specialized therapies.
  • Assessment and Plan of Care Development: Procedures for conducting comprehensive evaluations by licensed therapists to develop individualized plans of care (POCs). 
  • Provider Requirements: Standards for therapy providers, including licensure under applicable Texas Administrative Code provisions, compliance with Medicaid billing requirements, and training in evidence-based practices and patient rights.
  • Documentation and Prior Authorization: Requirements for maintaining accurate records of assessments, progress notes, treatment plans, incident reports, and prior authorization requests for Medicaid-covered therapy services.
  • Client Rights: Provisions to protect client rights, including informed consent for services, confidentiality of medical records, freedom from discrimination or neglect, and access to grievance procedures.
  • Safety Standards: Policies to ensure safe delivery of therapy services through proper equipment use, infection control protocols, and emergency preparedness training.
  • Quality Assurance: Policies for monitoring service effectiveness through performance reviews, client satisfaction surveys, audits by HHSC or accrediting bodies, and corrective action plans to address identified deficiencies.
The Texas Therapy Services Policy Manual serves as an essential resource for agencies and providers to deliver high-quality therapy services while adhering to state regulations. It supports improved client outcomes by fostering recovery, enhancing functional abilities, promoting independence, and ensuring continuity of care across diverse populations.
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