28 Tex. Admin. Code § 21.2427 - Plan Reimbursement Rates Compared with Medicare Rates
(a) Reporting worksheet. An issuer must
report the data required by this section within the "MH/SUD Parity Rule
Division 2 Data Collection Reporting Form" template in the worksheet titled
"Reimbursement Rates."
(b)
Categories of providers and billing codes. An issuer must report average plan
reimbursement rates separately for in-network and out-of-network providers for
services provided by the following categories of providers for the billing
codes specified by TDI in the worksheet:
(1)
orthopedic surgeons;
(2)
cardiologists;
(3)
internists;
(4)
endocrinologists;
(5)
gastroenterologists;
(6)
neurologists;
(7)
pediatricians;
(8)
dermatologists;
(9)
psychiatrists;
(10)
psychologists;
(11) licensed
clinical social workers;
(12)
podiatrists;
(13)
chiropractors;
(14) occupational
therapists; and
(15) physical
therapists.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.