New Medicaid Benefit: Prescribed Pediatric Extended Care Centers

Date: 12/06/16

Effective November 1, 2016, Prescribed Pediatric Extended Care Centers (PPECC) is a benefit of Texas Medicaid. PPECC services are provided in a non-residential facility to medically or technologically dependent minors, who are 20 years old or younger and require ongoing skilled nursing.

When prescribed by a provider, minors can attend a PPECC up to a maximum of 12 hours per day to receive medical, nursing, psychosocial, therapeutic and developmental services appropriate to their medical condition and developmental status. PPECC services are an alternative to private duty nursing. 

Providers can begin to submit prior authorization requests on December 10, 2016, with dates of service retroactive to November 1, 2016. Prior authorization requests or claims submitted prior to December 10, 2016 will be returned to the provider. Requests must be resubmitted for consideration starting December 10, 2016.

More information on PPECCs can be found on the Texas Health and Human Services website: Prescribed Pediatric Extended Care Centers

For questions, please contact your local Account Manager or Provider Services at 1-877-391-5921