HHSC: Hearing on Various Rate Proposals

The Texas Health and Human Services Commission (HHSC) conducted a public hearing to receive public comments on the following rate proposals: Medicaid payment rates for the Special Fee Review of the HCPCS Code: J0172 – Aduhelm. Long Acting Reversible Contraceptives (LARCS) Calendar Fee Review. Medical Transportation Program (MTP) Medical Policy Review of Prosigna Proposed Medicaid Payment Rates for the Special Fee Review of the HCPCS Code: J0172 - Aduhelm Proposal. The payment rate for the Special Fee Review of the HCPCS Code: J0172 - Aduhelm is proposed to be effective January 1, 2022. Methodology and Justification. The proposed payment rates were calculated in accordance with Title 1 of the Texas Administrative Code: §355.8085, which addresses the reimbursement methodology for physicians and other practitioners; and §355.8441, which addresses the reimbursement methodologies for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services (