- parent agency, branch, or change of ownership: $2,625
- alternate delivery site: $1,000.
- For two-year license:
- parent agency or branch: $1,750
- alternate delivery site: $600.
- parent agency or branch: $2,625
- alternate delivery site: $900.
- For two-year license:
- parent agency or branch: $875
- alternate delivery site: $300.
- parent agency or branch: $1,312.50
- alternate delivery site: $450.
Category of Services
Licensed and Certified Home Health
Must accept a person for home health services based on a reasonable expectation that their medical, nursing and social needs can be met adequately in their residence. Certified home health agencies must comply with the requirements of the Social Security Act and the regulations in Title 42 of the Code of Federal Regulations, Part 484.
Licensed Home Health
Must accept a person for home health services based on a reasonable expectation that the their medical, nursing and social needs can be met adequately in their residence.
Licensed and Certified Home Health with Home Dialysis Designation
Must accept a person for home health services based on a reasonable expectation that their medical, nursing and social needs can be met adequately in the client's residence. For a residence to receive a home dialysis designation, it must meet the licensing standards specified in Texas Administrative Code §558.405. Certified Home health agencies must comply with the requirements of the Social Security Act and the regulations in Title 42 of the Code of Federal Regulations, Part 484.
Licensed Home Health with Home Dialysis Designation
Must accept a person for home health services based on a reasonable expectation that their medical, nursing and social needs can be met adequately in their residence. For a residence to receive a home dialysis designation, it must meet the licensing standards specified in 26 TAC §558.405.
Hospice
Services, including those provided by unlicensed personnel under the delegation of a registered nurse or physical therapist, provided to the person in care or their family as part of a coordinated program. These services include palliative care for terminally ill people and support services for them and their families. Hospice services are available 24 hours a day, seven days a week. Certified hospice providers must comply with the requirements of the Social Security Act in Title 42 of the Code of Federal Regulations, Part 418.
Personal Assistance Services
Routine ongoing care or service required by a person in a residence or independent-living environment that enables them to engage in the activities of daily living or to preform functions required for independent living, including respite.
Time Frames for Applications
An application from an agency for an initial, renewal and change of ownership: parent, branch office or alternate delivery site license is processed in accordance with three general time frames:
- Upon receipt of a thoroughly complete application in TULIP, the HHS/HCSSA Licensing unit has up to 45 days to process the application.
- If HHS/HCSSA Licensing unit receives an incomplete application, the HHS/HCSSA Licensing unit will notify the HCSSA via TULIP of any deficient items in the application. The applicant must respond with complete and correct information within 30 days from the date of notification or the application will be denied.
- Upon receipt of the application deficiency response in TULIP, the licensing unit will issue or deny the license within 45 days unless other matters prevent the approval or denial of the application, for example a pending survey or enforcement recommendation.
NOTE: After an initial license is issued, the agency must notify the HHS regional office upon enrolling its first person under their care (If more than one category, the agency must enroll and provide surveys to the highest category) and request an initial health survey using the HHSC Form 2020, Notification of Readiness for Initial Survey. This survey request must be completed within six months of the issuance of the initial license. After an agency is issued a new change-of-ownership license, the agency must notify the HHS regional office within six months of the effective date of their new license. After an initial license is issued for an alternate delivery site with or without an inpatient unit, the hospice agency must notify the HHS regional office upon enrolling its first person under their care and request an initial health survey.
Changes of Information
Forms
Parent, Branch, Alternate Delivery Site and Medicare Branch Applications
Visit TULIP to access the applications and instructions page.
- Form 2021, Home and Community Support Services Agency Application for Parent (initials, renewals, change of ownership and changes of information to the parent agency), fees are non-refundable.
- Form 2023, Home and Community Support Services Agency Application for Initial Medicare Certified Branch, fees are non-refundable.
- Form 2024, Home and Community Support Services Agency Request for an Alternate Delivery Site License (initials, renewals, change of ownership and changes of information to the alternate delivery site, to include In-patient unit), fees are non-refundable. An Inpatient Hospice unit must contact the HHS Architectural Unit at 512-438-2311 to request a Life Safety Code survey before approval and an Impatient Hospice unit must notify their HHSC regional office upon enrolling its first person under their care and request an initial health survey.
- Form 2025, Home and Community Support Services Agency Request for a Branch License, (initials, Renewals, Change of Ownership and Changes of Information to the branch office), fees are non-refundable.
Statutes and Rules
HCSSA providers are responsible for reading and understanding the HCCSA regulations before becoming a licensed provider. Read all HCSSA Statutes and Rules.
Medicare Certification
Participation in the state and federal Medicaid program and federal Medicare program is voluntary. However, each agency must be certified for the appropriate Medicare program before serving people who are eligible.
As of January 30, 2019, there are no active Medicare Provider Enrollment Moratoria in Texas. An existing home health or hospice provider seeking Medicare certification should refer to the following provider letters, respectively.
- Provider Letter No. 15-09, Direction from the Centers for Medicare & Medicaid Services (CMS) on Prioritization of Initial Medicare Certification Surveys (Home Health) [PDF] (Note: This provider letter has not been updated to note the expiration of the moratorium)
- Provider Letter No. 15-10, Direction from the Centers for Medicare & Medicaid Services (CMS) on Prioritization of Initial Medicare Certification Surveys (Hospice) [PDF] related to requirement to use an Accrediting Organization for initial certification surveys.
The application will not be considered completed until verification of an initial certification survey is received from an AO or conducted by HHSC Survey Operations. Due to CMS workload prioritization directives, no initial certification surveys are being performed by HHSC Survey Operations.
Existing Licensed Providers seeking to add Medicare certification should submit an application through the TULIP system (Form 2021, Home and Community Support Services Agency License Application: Change-Update Category of Service), including the following documents to be uploaded into the application:
- CMS 1561: Health Insurance Benefit Agreement
- CMS 417 Request for Hospice certification, as applicable
- Verification of Office of Civil Rights Submission
New home health and hospice providers seeking licensure and Medicare certification should submit an application through the TULIP system (Form 2021, Home and Community Support Services Agency License Application: Initial). For a list of required documents, see the required documents for Medicare certification below.
Accreditation Agencies
- Community Health Accreditation Partner
- The Joint Commission
- Accreditation Commission for Health Care, Inc.
Required Documents for Medicare Certification
These documents are required if the agency is seeking certification or is currently certified through the Medicare program.
- Printed CMS 855A Home Health Enrollment Application (PDF) [Please read the instructions for how to submit this form to the fiscal intermediary].
- Online CMS 885A Home Health Enrollment Application.
- CMS 1561 Health Insurance Benefit Agreement (PDF) [with original signatures, completing the entire top half and signing under "Accepted for the provider of services by"].
- Civil Rights Clearance for Medicare Provider Applicants (copy of evidence of successful electronic submission through HHS Assurance of Compliance portal).
- CMS 417 Hospice Request for Certification in the Medicare Program (PDF) [with original signatures] only if requesting the category of certified hospice.
Attention: Home health and Hospices agencies that are (1) initially enrolling in Medicare, (2) adding a branch or multiple location, or (3) revalidating their enrollment information, must submit with their CMS 855 application:
- Verification of the application fee in an amount prescribed by CMS and/or
- A letter for a request for a hardship exception to the application fee.
The provider must pay the application fee electronically through Pay.gov, with a credit or debit card. The application fee applies to CMS 855 applications that the agency's Regional Home Health Intermediary/Medicare Administrative contractor.
The following links provides additional information and the current application fee process:
- CMS Home Health Center
- CMS Hospice Center
- Implementation of Provider Enrollment Provisions (PDF)
HHSC Contracting
When submitting an application through the online portal (TULIP), this action only applies to the license itself. HCSSA providers who also have contracts with HHSC need to contact their contract manager to discuss how a licensure action could impact the contract they hold.
For more information, see the following links:
- Medicaid Contracts
- Community Attendant Services (CAS)
- Family Care (FC)
- Primary Home Care (PHC)
Resources
- Medicare Enrollment Application
- Hospice Request for Certification in the Medicare Program (PDF)
- Health Insurance Benefit Agreement for Medicare Home Health (PDF)
- Medicare Conditions of Participation for Home Health and Hospice
- Office for Civil Rights
- Email the Oasis Help Desk
- Texas Department of Public Safety
- HCSSA Training Classes
- Board of Nursing
- Taxable Entity Search
