Overview
STAR Kids is a Texas Medicaid managed care program serving children and youth age 20 and younger who have Medicaid through SSI or 1915(c) waiver programs. STAR Health is a Texas Medicaid managed care program for children and youth in DFPS conservatorship, the Adoption Assistance or Permanency Care Assistance program, Extended Foster Care, or Former Foster Care Children (FFCC).
STAR Kids and STAR Health services are delivered through providers contracted by managed care organizations (MCOs). All members have access to service coordination, provided by an MCO employee or through a member's primary care provider. Members also receive a comprehensive assessment of their physical and functional needs by a service coordinator using the STAR Kids Screening and Assessment Instrument (SK-SAI) annually.
In addition to traditional Medicaid services, STAR Kids and STAR Health MCOs are responsible for delivering additional services to members enrolled in the Medically Dependent Children Program (MDCP). MDCP provides respite, flexible family support services, adaptive aids, minor home modifications, employment services, and transition assistance to children and young adults who meet the level of care provided in a nursing facility (NF), so they can safely live in the community.
Methodology/Rules
The Medically Dependent Children Program program-specific Reimbursement Methodology is located in Title 1 of the Texas Administrative Code, Part 15, Chapter 355, Subchapter E, Rule §335.507. This rule explains in detail how the MDCP payment rates are calculated.
Cost Determination Process Rules applicable to the Medically Dependent Children Program are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 355, SubChapter A, Rules 101-111 and 114.
Rules pertaining to the maintenance of contractor records for the Medically Dependent Children Program are located at Title 40 of the Texas Administrative Code, Part 1, Chapter 49, SubChapter C, Rule 49.307.
Payment Rate Information
Effective September 1, 2024 - State Plan Services (.pdf)
Effective January 1, 2024 - MDCP (.pdf)
Effective January 1, 2024 - State Plan Services (.pdf)
Effective September 1, 2023 - MDCP (.pdf)
Effective September 1, 2023 - State Plan Services (.pdf)
- Previous Payment Information
Effective September 1, 2022 (.pdf)
Effective September 1, 2019 (.pdf)
Effective September 1, 2015 (.pdf)
Effective September 1, 2014 (.pdf)
Effective September 1, 2013 (.pdf)
Effective February 1, 2011 (.pdf)
Effective September 1, 2010 (.pdf)
Effective September 1, 2009 (.pdf)
Effective August 1, 2009 (.pdf)
Effective September 1, 2008 (.pdf)
Effective August 1, 2008 (.pdf)
Effective September 1, 2007 (.pdf)
Effective August 1, 2007 (.pdf)
Effective September 1, 2006 (.pdf)
Effective September 1, 2005 (.pdf)
Effective September 1, 2004 (.pdf)
Effective September 1, 2003 (.pdf)
Effective September 1, 2002 (.pdf)
Effective September 1, 2001 (.pdf)