Texas Medicaid: Revenue code update for STAR Kids respite care
Effective July 1, 2023, the Texas Health and Human Services Commission (HHSC) will update the revenue code for STAR Kids respite care for Medically Dependent Children Program (MDCP).
Currently, the STAR Kids billing matrix reflects revenue code 661 (hourly/quarterly) to be billed with the HCPCS code S5151 for out-of-home respite (facility) for MDCP.
This is incorrect. The unit should be billed as a per diem rate. HHSC will correct this to show revenue code 663 (per diem) effective July 1, as shown below:
| Procedure code qualifier | HCPC codes | Rev codes | Mod 1 | Units | Service description |
|---|---|---|---|---|---|
| HC | S5151 | 663 | Per diem | Respite care, not hospice | |
| HC | S5151 | 663 | U1 | Per diem | Respite care, not hospice, with partial vent
|
| HC | S5151 | 663 | U2 | Per diem | Respite care, not hospice, with full vent |
| HC | S5151 | 663 | U3 | Per diem | Respite care, not hospice, with trach |
Background
On Dec. 1, 2022, the HHSC revised the billing matrix for STAR Kids and STAR+PLUS Long-Term Services and Supports (LTSS). At that time, they changed the HCPC code to S5151 and the billing units to per diem.
Learn more
Go to our LTSS STAR+PLUS and MMP and STAR Kids (including MDCP) Codes and Modifiers Guide for more information. You can also visit HHSC to view the complete STAR Kids LTSS Billing Matrix and Crosswalk.
Questions?
Contact us for answers to general questions.
