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HB 4760

Relating to Medicaid reimbursement for the costs of cognitive assessment and care planning services provided to certain patients.

89th Legislature (2025) Introduced by Senfronia Thompson

Texas bill expands Medicaid to reimburse cognitive assessment and care planning services for specified patient populations.

Referred to Human Services
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Bill Summary · HB 4760

Legislative bill overview

HB 4760 would expand Medicaid reimbursement coverage to include cognitive assessment and care planning services for certain patient populations in Texas. The bill specifically targets reimbursement for evaluations and planning services related to cognitive conditions, allowing providers to bill Medicaid for these previously uncovered or partially covered services.

Why is this important

Cognitive assessments and care planning are critical for diagnosing and managing conditions like dementia, Alzheimer's disease, and other cognitive impairments, yet coverage gaps often prevent patients from accessing these services. Expanding Medicaid reimbursement could improve early detection and care coordination while reducing downstream costs from untreated cognitive decline, particularly for low-income Texans who rely on Medicaid.

Potential points of contention

  • Cost to state budget: Expanding Medicaid reimbursement increases state expenditures, which requires either funding adjustments elsewhere or federal matching funds; lawmakers will debate affordability given existing budget constraints
  • Definition of "certain patients": The bill's reference to "certain patients" lacks specificity about eligibility criteria, raising questions about who qualifies and whether the definition is appropriately narrow or too broad
  • Provider capacity and billing standards: Questions exist about whether sufficient providers are available to deliver these services, whether billing standards are clearly defined to prevent fraud or abuse, and whether reimbursement rates are adequate to incentivize participation

Compiled from official sources — confirm details with the bill’s official record.

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