# 1 Tex. Admin. Code § 363.307: 1 TAC § 363.307. Medical Necessity

> Texas · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C363_S363_307

## Section

- **Citation:** 1 Tex. Admin. Code § 363.307
- **Heading:** 1 TAC § 363.307. Medical Necessity
- **Jurisdiction:** Texas
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Texas Administrative Code / Title 1 ADMINISTRATION / Part 15 TEXAS HEALTH AND HUMAN SERVICES COMMISSION / Chapter 363 TEXAS HEALTH STEPS COMPREHENSIVE CARE PROGRAM / 1 TAC § 363.307

## Text

(a) PDN services are available to EPSDT-eligible recipients
 when the services are medically necessary to correct or ameliorate
 the recipient's disability or physical or mental illness or condition.
 The services correct or ameliorate when they improve, maintain, or
 slow the deterioration of the recipient's health status.
(b) Medical necessity must be documented in the recipient's
 prior authorization request.

## Nearby sections

- [1 Tex. Admin. Code § 363.301 1 TAC § 363.301. Purpose](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C363_S363_301.md)
- [1 Tex. Admin. Code § 363.303 1 TAC § 363.303. Definitions](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C363_S363_303.md)
- [1 Tex. Admin. Code § 363.305 1 TAC § 363.305. Provider Participation Requirements](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C363_S363_305.md)
- [1 Tex. Admin. Code § 363.307 1 TAC § 363.307. Medical Necessity](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C363_S363_307.md)
- [1 Tex. Admin. Code § 363.309 1 TAC § 363.309. Benefits and Limitations](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C363_S363_309.md)
- [1 Tex. Admin. Code § 363.311 1 TAC § 363.311. Prior Authorization Requirements](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C363_S363_311.md)
- [1 Tex. Admin. Code § 363.313 1 TAC § 363.313. Plan of Care](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C363_S363_313.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C363_S363_307. Check the current official text before relying on it. Not legal advice.