PPECC Starter
Texas PPECC Resource
Start Readiness Map Requirements
PPECC Starter — Texas PPECC Operating Resource

Thinking about starting a PPECC in Texas?

Starting a Texas PPECC isn't just a licensing project. It's an operating-system design problem — skilled nursing, therapy coordination, attendance, authorizations, documentation, medical records, QAPI, survey readiness, and billing evidence all need to work together before the first child walks in the door.

PPECC is not a generic care setting

A PPECC is purpose-built for medically complex children

Texas PPECCs serve children who need nonresidential skilled care in a licensed, center-based environment. That is not the same as:

Ordinary child care — PPECC requires licensed skilled nursing and clinical oversight.
Home health — PPECC operates in a licensed facility, not at a child's home.
An adult facility — pediatric staffing ratios, care models, and documentation requirements are fundamentally different.
A therapy clinic — therapy at a PPECC is one part of an interdisciplinary care model that also includes skilled nursing, attendance, authorizations, and daily documentation.
A billing operation — reimbursement at a PPECC is downstream of clinical documentation, authorization management, and operational readiness.
What founders need to map

A Texas PPECC requires operational readiness
across 10 domains before the first child arrives

This resource helps founders map the operating record they will need.

Licensing path

HHSC licensing application, mandatory CBT training through TULIP, initial survey preparation, and provisional vs. standard license requirements.

Facility readiness

Physical plant, equipment, ADA compliance, safety requirements, and inspection baseline per Texas HHSC PPECC licensing standards.

Clinical leadership

Medical director relationship, Director of Nursing qualification, credentialing, and governance documentation.

Nursing operations

RN/LVN staffing ratios, shift patterns, competency documentation, nursing documentation standards, and plan-of-care adherence.

Therapy / rehabilitative services

PT, OT, speech-language pathology, and developmental therapy — session documentation, plan-of-care alignment, and authorization periods.

Admissions and care planning

Eligibility determination, physician orders, interdisciplinary plan of care, admission packet completeness, and enrollment documentation.

Medical records

Medical record structure, content requirements, retention policy, and audit defensibility.

Attendance and census

Daily census, transportation documentation, attendance-to-authorization reconciliation, and census reporting requirements.

QAPI and survey readiness

Quality assurance and performance improvement program, inspection preparation, corrective action readiness, and ongoing survey risk management.

Medicaid / billing evidence

TMHP provider enrollment, Medicaid documentation requirements, prior authorization, and billing evidence organization.

See all 15 readiness domains →

Source-backed requirements

Every PPECC requirement traces to an official source

This resource is built around official HHSC, Texas Administrative Code, and TMHP sources — each with a URL, effective date, and retrieval date. No claim is published without a confirmed official source.

Clinical Leadership

Nursing Director Qualifications

26 TAC §550.309 · Effective Oct 16, 2024 · Retrieved 2026-06-03

✓ Approved
Nursing Operations

Minimum Staffing Ratio

26 TAC §550.410 · Effective Oct 16, 2024 · Retrieved 2026-06-03

✓ Approved
Plan of Care

POC Physician Signature Window

26 TAC §550.607 · Effective Oct 16, 2024 · Retrieved 2026-06-03

✓ Approved

Browse the Requirements Library →

Readiness Map

Map your operating readiness across 15 domains

The Texas PPECC Readiness Map walks founders through 15 operational domains — from licensing and facility readiness to billing evidence and survey readiness.

No PHI. No compliance determination. Planning awareness only.

49 questions across 15 operating domains. No PHI. Planning awareness only.

Texas PPECC Reimbursement / Rate Watch

PPECC services are reimbursed through Texas Medicaid — CSHCN FFS (TMHP) and STAR Kids managed care. The billing code structure below is confirmed per TMHP Form F00124 (effective December 1, 2024).

T1025
Per diem — used on days when PPECC services exceed 4 hours. T1025 and T1026 may not both be billed on the same day.
T1026
Hourly — used on days when PPECC services are 4 hours or less. Limited to 12 hours/day and 400 hours/calendar year.
T2002
Transportation — per diem, billed separately. Does not count toward the 400-hour annual limit.

Current dollar rates require direct verification from the TMHP fee portal (public.tmhp.com/FeeSchedules). This resource does not publish current rate amounts until they are verified from an official current-date source.

Billing code structure confirmed via TMHP F00124 (Instructions for Completing PPECC Prior Authorization Forms), effective December 1, 2024. No current dollar amounts are published.

Optional next step with Harbor

Ready to go further? Harbor is a PPECC-native operating record.

Once you have a picture of your operating-readiness stage, Harbor helps map and build the documentation and workflow model your PPECC will need — before workflows become scattered across paper, portals, and mismatched software.

  • Helps organize the documentation, workflows, and readiness mapping a PPECC requires.
  • Surfaces operating-model questions that need answers before a center opens — nursing, therapy, admissions, QAPI, and billing evidence.
  • Connects clinical documentation, authorization tracking, attendance, and billing evidence so they stay aligned from the first day of operations.
  • Supports medical-record readiness, plan-of-care management, survey evidence organization, and therapy coordination.
  • Provides a state-aware BuildPlan funnel that maps your operating profile and surfaces where readiness gaps are likely.
Harbor does not guarantee licensure, Medicaid enrollment, reimbursement, or survey outcomes. Opening a Texas PPECC requires engagement with Texas HHSC, TMHP, licensed clinicians, legal counsel, architects, and other qualified professionals who are outside Harbor’s scope. Harbor is not a certified EHR and does not handle the HHSC licensing application.
Harbor free trial → Build Your Operating Blueprint

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Guidance backed by official Texas sources

Texas PPECC guidance on this site is derived from official HHSC, Texas Administrative Code, and TMHP sources — each with a URL, effective date, and retrieval date. Every requirement traces to an official primary source before it is published.

Browse the Requirements Library →

This resource is for operating awareness and planning support only. It is not legal, clinical, billing, licensing, architectural, or reimbursement advice. Always verify requirements with official sources and qualified professionals. Texas PPECC licensing and Medicaid enrollment require engagement with Texas HHSC, TMHP, and qualified professionals.