Rate Analysis for Hospital and Clinic Services
The Health and Human Services Commission (HHSC) Rate Analysis for Hospital Services develops reimbursement methodology rules for determining payment rates/fees for Medicaid Hospital Services. General Medicaid program rules for Hospital Services are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 354, SubChapter A, Division 10, Rule §354.1121. Additional general Medicaid program rules for Hospital Services are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 354, SubChapter A, Division 11, Rules 1131-1190. HHSC Rate Analysis for Hospital Services develops payment rates/fees in accordance with published rules and policy guidelines for Hospital Services.
The Texas Health and Human Services Commission (HHSC) has received approval from the Centers for Medicare and Medicaid Services (CMS) to implement the Uniform Hospital Rate Increase Program (UHRIP) for hospital services beginning March 1, 2018, in the El Paso and Bexar managed care service deliver areas (SDA) and is currently seeking approval for additional SDAs. If approved, the rate increases would reduce hospitals' Medicaid shortfall in the SDAs in which the program is implemented. Further information on the UHRIP program may be obtained on our Uniform Hospital Rate Increase Program page.
SDA Add-On status verification is in process through July 27, 2017. Please review your SDA Add-On information and submit any changes on the Status Verification form.
Programs and Services
Note: Rate Analysis staff can assist you with questions concerning only payment rates for the specified services. They are not able to answer other types of questions, such as the status of payment for services rendered or questions involving eligibility for care services.
If you have questions regarding Hospitals - Inpatient and Outpatient Hospital Services payment rates, please call the appropriate person on the Contacts List.
If you have questions regarding Hospitals program/policy issues, please call the TMHP Contact Center at 1-800-925-9126.
Updated: June 7, 2017