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 Texas Home Health Regulations

Types of Home Health Services

Home health nurse with patient.

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Texas Health and Human Services (HHS) licenses, certifies and surveys Home and Community Support Services Agencies (HCSSAs) (HCSSAs) for compliance with state and federal laws and regulations. Through these regulatory activities, HHS protects Texas citizens receiving home health, hospice and personal assistance services.

Home health care includes skilled nursing care as well as other skilled care services such as physical and occupational therapy, speech- language therapy, and medical social services. These services are provided by a variety of skilled health care professionals in one's home.

Home Healthcare and Medicare

Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) covers eligible home health services including Intermittent skilled nursing care, Physical therapy, Speech and language pathology services. You can get 100% of the costs covered if your doctor deems skilled rehabilitation or nursing services necessary for the short term and writes and order for it.

Home Healthcare May Include:

  • Nursing care - The most common form of home health care is some type of nursing care depending on the person's needs. In consultation with the doctor, a registered nurse will set up a plan of care. Nursing care may include wound dressing, ostomy care, intravenous therapy, administering medication, monitoring the general health of the patient, pain control, and other health support.

  • Homehealth aide with elderly woman.Physical, occupational, and/or speech therapy - Some patients may need help relearning how to perform daily duties or improve their speech after an illness or injury. A physical therapist can put together a plan of care to help a patient regain or strengthen use of muscles and joints. An occupational therapist can help a patient with physical, developmental, social, or emotional disabilities relearn how to perform such daily functions as eating, bathing, dressing, and more. A speech therapist can help a patient with impaired speech regain the ability to communicate clearly.

  • Medical social services - Medical social workers provide various services to the patient, including counseling and locating community resources to help the patient in his or her recovery. Some social workers are also the patient's case manager--if the patient's medical condition is very complex and requires coordination of many services.

  • Laboratory and X-ray imaging - Certain laboratory tests, such as blood and urine tests, can be performed in the comfort of the patient's home. In addition, portable X-ray machines allow lab technicians to perform this service at home.

  • Homemaker or basic assistance care. While a patient is being medically cared for in the home, a homemaker or person who helps with chores or tasks can maintain the household with meal preparation, laundry, grocery shopping, and other housekeeping items.

  • Pharmaceutical services - Medicine and medical equipment can be delivered at home. If the patient needs it, training can be provided on how to take medicines or use of the equipment, including intravenous therapy.

  • Nutritional support - Dietitians can come to a patient's home to provide dietary assessments and guidance to support the treatment plan.

Frequently Asked Questions of Home Healthcare Services. 

Question: Can I receive other services?

Answer: If you need in-home nursing or rehabilitative care, you may also need help with activities of daily living such as bathing, dressing, and light housekeeping; these services may also be provided through a home health agency. Some offer long-term nursing and other services on a more permanent basis, although these services may not be covered by Medicare or most health insurance policies.

Question: Where can I find Texas home health?

Answer: Usually, you would get a referral to a local home health care agency from your hospital or doctor. You can also check online. If you're looking for yourself, be sure that the agency is certified by the Department of Health or the appropriate agency or organization in your state. Your Department of Health may provide a list of certified home health agencies in your state.

Question: How do I know if I need home health?

Answer: Usually, your doctor will refer you to one if you need one-and you can't get Medicare coverage for these services without a doctor's referral. In general, however, a home health agency's services may be needed if you or a loved one prefers to stay home-or has been discharged from the hospital-but still needs more care than the family is capable of providing.

Not all home health agencies in Texas are the same, and depending on your state, conditions may vary in terms of the types of services the agency can provide and what is covered by insurance. However, if you start with a doctor or hospital referral, you are likely to be able to find an agency that can provide you with the services you need.

Question: Is home health covered by Medicaid?

Answer: Texas covers home health services under its Medicaid program. If your doctor prescribes home health services like nursing or therapy services in your plan of care for a particular medical condition, Medicaid will cover those. Medicaid reviews your need for home health care every 60 days.

You do not need to meet the nursing home level of care to qualify for home health services. However, because these Medicaid-funded home health services are related to a doctor's plan of care for a particular medical condition, they are generally offered on a short-term basis.

For more information and to apply for Primary Health Care Program Services Program, contact the Texas Health and Human Services PHC Program. Medicaid covers home health care for eligible Medicaid recipients. Individuals have to meet both federal and state regulations to receive covered home health care services. Medicaid does not limit the services simply to the term "Home health care." Medicaid covers a wide variety of home health-related services.


Home and Community Support Services Agencies (HCSSAs) must be licensed to operate in Texas. To become licensed, an agency must complete the following, so it's important to ask if they are licensed by the state.

  • Complete the pre-survey, computer-based training.
  • Properly complete the license application.
  • Upload all required documents.
  • Pay the required license fee(s).
  • Be registered with and be in good standing from the State Comptroller of Public Accounts.
  • Be registered with and be in good standing from the Secretary of State of Texas.
  • Be approved by HHS/HCSSA Licensure and Certification Unit.


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