Provider Alert! Change to Signature Requirements for Title XIX (Medicaid) Home Health Services

Provider Alert!

Provider Alert! Change to Signature Requirements for Title XIX (Medicaid) Home Health Services

Date: October 27, 2022

Attention: Home Health Providers

Effective date: September 21, 2022

Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.

Call to action: The purpose of this communication is to inform providers that the Health and Human Services Commission (HHSC) has recently adopted rules in alignment with 42 Code of Federal Regulations §440.70. The adopted rules for home health services became effective on September 21, 2022.

Amendments to 1 Texas Administrative Code rules 354.1031, 354.1035, 354.1037, 354.1039, 354.1040, and 354.1043 bring Texas into compliance with the Centers for Medicare & Medicaid Services CMS-5531-Interim Final Rule with Comment (IFC).

How this impacts providers: Signature requirements for Title XIX (Medicaid) Home Health Services have changed. Medicaid-enrolled physicians and allowed practitioners can now sign prior authorizations and order covered Medicaid Home Health Services, including the following:

  • Skilled nursing
  • Home health aide services
  • Durable medical equipment and supplies
  • Adult physical and occupational therapy services

An allowed practitioner is a physician assistant (PA) or an advanced practice registered nurse who is licensed as a certified nurse practitioner (CNP) or clinical nurse specialist (CNS).


eCFR :: 42 CFR 440.70 — Home health services.

Next steps for providers: Providers should share this communication with their staff.

If you have any questions, please email Provider Relations at:

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