Volume XXXI, Number 6
Provider Letter No. 16-17 — Supporting Physician Documentation
NEW Provider letter serves as a reminder of the rules that require documentation related to physician services. If you do not maintain documentation required, DADS may penalize you.
Outline in the provider letter is the following guidance for Nursing Facilities:
In accordance with Texas Administrative Code, Title 40, Part I, Chapter 19 (40 TAC), §19.1202, Physician Visits, a physician must:
In accordance with 40 TAC §19.1203(2) Frequency of Physician Visits, a resident of a Medicaid-certified nursing facility or a Medicare skilled nursing facility must be seen by a physician at least once every 30 days for the first 90 days after admission, and at least once every 60 days thereafter. In a Medicare skilled nursing facility, a physician may delegate this requirement to certain health care providers in accordance with §19.1203(3) and §19.1205. Section 19.1203 also provides that physician visit is considered timely if it occurs not later than ten days after the visit is required.
To view the Provider letter click HERE.
Commitment to Care
If you have any questions about the THCA Commitment to Care Initiative or would like to share your facilities successes please contact Gloria Bean-Williams by email or call (512) 458-1257.
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