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The $250,000 letter of credit is a bank-issued financial instrument — not a cash reserve. Engage your bank early; LoC issuance lead time varies by institution.
§§248A.001–248A.263
Complete the HHSC PPECC CBT before applying — it is a hard prerequisite gate. Build CBT completion into your pre-application timeline, at least 30 days before your target application submission date.
All licensing paperwork flows through TULIP. Plan for portal registration, CBT completion, and document upload workflows. Paper or email applications are not accepted.
§550.101 et seq. (chapter-level only)
Budget for the $2,625 initial application fee and a $250,000 letter of credit before applying. These are upfront capital requirements.
The Medical Director requires active Texas licensure and current pediatric board certification — a general physician license without pediatric board cert does not satisfy this requirement.
The DON is a full-time employment commitment — contractor or part-time arrangements do not satisfy this requirement. Hire a qualified DON before the HHSC initial survey.
The 1:3 floor means census planning and staffing scheduling must be tightly coordinated. Operational models that assume flexible or lower ratios will not meet the standard.
The three-business-day nursing assessment window starts on admission. Workflows must ensure an RN completes the assessment within this window for every admitted minor.
Therapy billing requires prior authorization and session documentation aligned with TMHP standards. Therapy providers must hold appropriate Texas licensure.
The admissions workflow must document physician orders, TMHP eligibility confirmation, and intake assessments per §550.604. Build a structured admissions checklist that tracks completion of each required element before care begins.
§§248A.151–248A.152 (chapter-level only)
The POC workflow must track two separate physician signature timelines: the HHSC 30-day licensing standard (§550.607) and the TMHP CSHCN 14-day billing window (see TX-PPECC-POC-002). Conflating the two creates compliance risk.
Tracking only one POC timeline misses the other. Design workflows to satisfy both: the HHSC 30-day licensing standard (TX-PPECC-POC-001) AND the TMHP 14-day billing window. Both are required; neither replaces the other.
The POC template must include a transportation stability section documenting how each minor's transportation to and from the PPECC is arranged. Older POC templates may not include this section — update before December 1, 2024 compliance baseline.
Medical record design must satisfy §550.803 HHSC standards AND TMHP billing documentation requirements layered on top. Plan for a record structure that captures both sets of elements, attributed to their respective sources.
§550.1004 (chapter-level only)
A written QAPI program must exist before the PPECC opens — not after. The initial HHSC survey will look for evidence that a QAPI program is in place. Design your QAPI structure as part of pre-opening planning.
QAPI is an ongoing process with structured data collection cadences — not a one-time setup document. Build quarterly data review cycles and an annual evaluation process into your operational calendar from day one.
Transportation log design must satisfy both the HHSC licensing standard (§550.1101) and the TMHP December 2024 billing documentation standards. A log meeting §550.1101 only may create billing documentation gaps. Build a unified log capturing all required elements from both sources.
The transportation log (TX-PPECC-TRN-001) and POC transportation stability documentation (TX-PPECC-POC-003) form the billing evidence foundation for T2002 claims.
All three PA documents must be complete and signed before submission. Missing the nursing addendum or an unsigned F00122 are common PA rejection causes. Build your PA workflow to assemble all three documents before submission.
Enroll as a TMHP CSHCN provider AND contract with relevant STAR Kids MCOs before admitting the first Medicaid child. Dual-channel operations require separate billing and authorization processes.
TMHP provider enrollment must be complete before billing CSHCN FFS claims. Begin PEMS enrollment concurrent with the HHSC licensing application process — not after licensure is received.
Daily documentation must capture whether each service day exceeds four hours, because this determines which billing code applies. A model that does not distinguish service-day duration from the outset creates a billing-evidence gap from day one.
Track each child's T1026 hour utilization against the 400-hour annual limit. Children who reach the CSHCN limit mid-year may require STAR Kids MCO authorization or alternatives. Build utilization tracking into the billing evidence workflow from day one.
Unannounced inspections mean operations must be continuously survey-ready — not only when an inspection is anticipated. Build survey-ready operations from day one: staffing ratios, documentation, QAPI program, and physical plant must meet standards at all times.
Deficiency citations require a documented corrective action response within 10 days. Be familiar with Form 3724 and have a clear escalation path for coordinating a timely plan of correction.
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Planning awareness only — not legal, clinical, billing, reimbursement, architectural, or licensing advice. Verify every requirement against the cited source and qualified professionals.