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Patient Driven Payment Model for Long-Term Care Rate Setting Methodology for Nursing Facilities


Rider 25 in the 2024-25 General Appropriations Act (GAA), House Bill 1, 88th Legislature, Regular Session, 2023 (Article II, Health and Human Services Commission, Rider 25) provides appropriations for The Texas Health and Human Services Commission (HHSC) to “develop and implement a Texas version of the Patient Driven Payment Model (PDPM) methodology for the reimbursement of long-term stay nursing facility services in the Medicaid program to achieve improved care for long-term stay nursing facility services, excluding services provided by a pediatric care facility or any state-owned facilities.”

Methodology / Rules

Proposed Texas Administrative Code Amendments for PDPM LTC Rate Methodology

HHSC has published the proposal preamble and proposed text of the rules regarding the Patient Driven Payment Model for Long-Term Care Rate Methodology for Nursing Facilities as they appear in the Texas Register.

Proposed Preamble and Proposed Rule Text (.pdf)

The public comment period on the rule proposal ends on June 3, 2024. HHSC will also be conducting a public hearing to receive comments on the proposed Title 1 Texas Administrative Code (TAC) amendments to implement the Nursing Facility Patient-Driven Payment Model (PDPM) for Long-Term Care (LTC) Rate Methodology. The hearing will occur on May 21, 2024, at 9:00 a.m. Central Daylight Time (CDT), in the HHSC John H. Winters Building, Public Hearing Room 125W, First Floor, 701 W. 51st St. Austin, TX 78751. Written comments regarding the proposed rules may be submitted to instead of, or in addition to, oral testimony until 11:59 p.m. on June 3, 2024.

Webinar: Overview of the Proposed Nursing Facility Patient Driven Payment Long-Term Care (PDPM LTC) Rate Methodology.

View the April 12, 2024 Webinar Recording (.wmv)

View the April 12, 2024 Webinar Presentation (.pdf)

PDPM LTC Overview 4-12-24 Webinar-FAQ (.pdf)