Get Tx 8606-a 2011-2025

Filling out the TX 8606-A form is an important step in ensuring proper documentation for therapy services under the Community Living Assistance and Support Services (CLASS) program. This guide will provide you with clear, step-by-step instructions to navigate the form efficiently.

Follow the steps to complete the TX 8606-A form with ease.

1. Press the ‘Get Form’ button to access the TX 8606-A form and open it in your editing tool.
2. Fill in the individual's name at the top of the form, followed by their Medicaid number to identify the person receiving services.
3. Enter the case management agency (CMA) name and the CMA vendor number to provide details of the managing agency.
4. Specify the requested skilled or specialized therapy in the designated field, ensuring you detail the specific type of service needed.
5. List all non-waiver resources that have been exhausted before requesting these therapy services, demonstrating the need for assistance.
6. The case manager must sign and date the form in the signature area to authorize the request.
7. In the section for the appropriate professional, provide the diagnosis, a brief description of the need for services, and outline specific qualifying conditions requiring treatment.
8. Describe or attach a comprehensive plan for interventions, including baseline data, goals, objectives in observable and measurable terms, and detail the implementation process, such as the scope, duration, amount, frequency, and location of services.
9. Indicate if components of the requested service can be delivered by someone other than a therapist by selecting 'Yes' or 'No.' If 'No,' describe the components requiring a licensed or certified professional.
10. Develop a plan for transferring therapy services to a non-therapist, explaining how the therapist will shift to a supervisory role over the non-therapist.
11. The professional providing the diagnosis must sign, print their name and title, and provide their area code and telephone number along with the date.
12. If applicable, include the professional's license number in the designated space to validate qualifications.
13. Once all sections are filled out, save your changes, then download, print, or share the completed TX 8606-A form as necessary.

Complete your TX 8606-A form online today and ensure your therapy services are documented properly.