The provider agency must maintain service delivery documentation that contains:
  (1) the name of the person delivering the services;
  (2) the client's name;
  (3) the client's Medicaid number;
  (4) the specific coverage period, including month, day, and year, as applicable;
  (5) the tasks assigned;
  (6) the units of service delivered;
  (7) the dates of service delivery; and
  (8) certification that the documented services were delivered.

Source Note: The provisions of this §58.133 adopted to be effective April 1, 2004, 29 TexReg 2381