January 11th, 2023
Revised Information Letter (IL) 2023-01 related to ISS Payment Rates (replaces IL 2022-56):
HHSC has published Revised Information Letter (IL) 2023-01, which replaces 2022-56 related to payment rates for Individualized Skills and Socialization Services, effective January 1, 2023.
HHSC has also approved payment rates for the Individualized Skills and Socialization in the Deaf Blind with Multiple Disabilities waiver (DBMD), Home and Community-based Services waiver (HCS), and Texas Home Living waiver (TxHmL) programs, effective January 1, 2023.
- The revised Individualized Skills and Socialization payment rates for these programs can be accessed on the Provider Finance Department Long-term Services & Supports webpage.
- The Long-term care HHSC Bill code Crosswalks which is used to match the Texas Long-term Care (LTC) Local Codes (i.e., bill codes) to the National Standard Procedure Codes (e.g., procedure, item, revenue codes) and claim payment for services is available on the HHSC Long-term Care Bill Code Crosswalk page.
Contact PFD-LTSS@hhs.texas.gov or (737) 867-7817 if you have questions.
December 06, 2022
Last Friday HHSC posted the ISS rates which may be viewed at the link below.
- The on and off-site ISS rates are effective January 1, 2023. It appears to be unlikely any of the licenses for ISS will be approved by that time.
- The current in and out-of home DH rates will remain effective through February 28, 2023.
- ACRE will not be available for the ISS service.
- This is because the current DH rate is a daily rate; the ISS rate is an hourly rate.
- Restructuring this component of ACRE will necessitate additional funds which HHSC will be requesting from the 88th Texas Legislature. Unfortunately, once received access to funds will not be available until September 1, 2023 and which providers choosing to participate in ACRE can request during the July, 2023 enrollment period.
- Though the ISS rules have yet to be adopted (hopefully by no later than December 16th), the proposed rules allow persons with a medical or behavioral justification to receive in-home ISS.
- proposed rules also state that if requested, a person who is 55 or older may also receive in-home ISS.
- The provider of the in-home ISS service does not need to be a licensed ISS provider.
- Note: As proposed, the rules do not address whether persons with the aforementioned justification or request can also participate in community activities and bill for off-site ISS. Though assumed this will not be permitted, we are still waiting for a response.
- The off-site rates allow for two levels of enhanced staffing. Though the proposed rules did not call for two levels of enhanced staffing, the adopted rules will.
- The adopted rules will also change the ratios at least for the ‘LON 1 and LON 5 without enhanced staffing’ category.
September 27th, 2022
Please see the newly proposed ISS (Individualized Skills & Socialization) rates. The proposed rates would be effective January 1st, 2023, if accepted, at the following link: https://pfd.hhs.texas.gov/sites/rad/files/documents/2023/01-01-2023-pmnt-rates-individualized-skills-socialization-%20srvcs.pdf
The recording can be accessed on-demand after the hearing at https://hhs.texas.gov/about-hhs/communications-events/live-archived-meetings.