Alaska Administrative Code
Title 7 - Health and Social Services
Part 8 - Medicaid Coverage and Payment
Chapter 145 - Medicaid Payment Rates
Article 9 - Payment Rates; Facility and Facility-Based Services
7 AAC 145.620 - Residential psychiatric treatment center payment rate

Universal Citation: 7 AK Admin Code 145.620

Current through November 28, 2024

(a) Except as provided in (b) of this section, the department will pay for residential psychiatric treatment center services provided in accordance with 7 AAC 140.400 - 7 AAC 140.415 at the daily rate determined under (c) of this section.

(b) The department will pay a provider separately for

(1) psychological testing and evaluation services if those services are not available through the residential psychiatric treatment center; in this paragraph, "psychological testing and evaluation" means the administration of standardized psychological tests and interpretation of findings by a psychologist, a psychological associate, or another mental health professional clinician with appropriate education and training, for the purpose of providing assistance in the psychiatric diagnosis of mental and emotional disorders or the assessment of functional capabilities;

(2) prescription drugs and other covered services provided directly by a physician or advanced practice registered nurse; or

(3) other necessary covered medical or dental services not related to the residential psychiatric treatment center admission.

(c) The department will pay a daily rate for residential psychiatric treatment facility services at the lesser of the following rates:

(1) the amount charged by the provider under 7 AAC 145.020; or

(2) the rate established in the department's Chart of Psychiatric Residential Treatment Facility Rates, adopted by reference in 7 AAC 160.900.

(d) On or after July 1,2025, the rates of payment in the department's Chart of Psychiatric Residential Treatment Facility Rates, adopted by reference in 7 AAC 160.900, will be reestablished at least every four years using a modeled rate methodology including

(1) components for treatment hours, staffing ratios, salaries, fringe benefits, productivity, program support, and administrative costs; and

(2) Information from the Department of Labor and Workforce Development, the United States Internal Revenue Service; and provider surveys.

(e) Each July 1, if the rates of payment in the Chart of Psychiatric Residential Treatment Facility Rates, adopted by reference in 7 AAC 160.900, are not reestablished under (d) of this section, the department will adjust the rates of payment in the Chart of Psychiatric Residential Treatment Facility Rates for inflation using the Centers for Medicare and Medicaid Services (CMS) Home Health Agency Market Basket in the most recent quarterly publication of Global Insight's Healthcare Cost Review available 60 days after July 1.

(f) Notwithstanding (c), (d), and (e) of this section, the department will pay a flat rate of $211 per day to a residential psychiatric treatment center for each therapeutic transition day authorized for a recipient under 7 AAC 140.405(g). In this subsection, "therapeutic transition day" means a calendar day related to a hospitalization in a residential psychiatric treatment center that is authorized by the department for payment for services for a recipient under 21 years of age who has been stabilized and is therefore ready fortransition or discharge.

Authority:AS 47.05.010

AS 47.07.030

AS 47.07.040

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