Texas § HR.32.03126 - REIMBURSEMENT FOR CHILDHOOD CRANIAL REMOLDING ORTHOSIS

§ HR.32.03126. REIMBURSEMENT FOR CHILDHOOD CRANIAL REMOLDING ORTHOSIS

REIMBURSEMENT FOR CHILDHOOD CRANIAL REMOLDING ORTHOSIS. (a) In this section, "cranial remolding orthosis" means a custom-fitted or custom-fabricated medical device that is applied to the head to correct a deformity, improve function, or relieve symptoms of a structural cranial disease. (b) The commission shall ensure medical assistance reimbursement is provided to cover in full the cost of a cranial remolding orthosis for a child who is a medical assistance recipient and has been diagnosed with: (1) craniosynostosis; or (2) plagiocephaly or brachycephaly if the child: (A) is not less than three months of age and not more than 18 months of age; (B) has had documented failure to respond to conservative therapy for at least two months; and (C) has one of the following sets of measurements or indications: (i) asymmetrical appearance confirmed by a right/left discrepancy of greater than six millimeters in a craniofacial anthropometric measurement; or (ii) brachycephalic or dolichocephalic disproportion in the comparison of head length to head width confirmed by a cephalic index of two standard deviations above or below mean. (c) The coverage required under this section may not be less favorable than the coverage required for other orthotics under the medical assistance program. Added by Acts 2025, 89th Leg., R.S., Ch. 719 (H.B. 426 ), Sec. 2, eff. September 1, 2025.