Texas MedicaidLow ImpactReimbursement

PDPM Model Long-term Care Methodology and Annual Patient Care Expense Ratio for NFs IL 2026-03 Now Published

Published February 10, 2026Effective September 1, 2025

AI Summary

HHSC has published Information Letter 2026-03 detailing the Patient Driven Payment Model Long-term Care Methodology and Annual Patient Care Expense Ratio for Nursing Facilities, effective September 1, 2025. This policy specifically impacts nursing facility billing and reimbursement methodologies in Texas.

Action Required

Before September 1, 2025: Nursing facility billing teams must review Information Letter 2026-03 on the HHSC Provider Finance Department webpage to understand updated PDPM methodology and patient care expense ratios. Contact HHSC PFD-LTSS at PFD-LTSS@hhs.texas.gov or (737) 867-7817 with questions. Update billing processes according to new PDPM requirements.

Plan Types

Medicaid

States

TX

Specialties

geriatrics