New York Codes, Rules and Regulations
Title 14 - DEPARTMENT OF MENTAL HYGIENE
Chapter XIII - Office of Mental Health
Part 588 - Medical Assistance Payment For Outpatient Programs
Section 588.10 - Standards pertaining to reimbursement for intensive psychiatric rehabilitative treatment programs

Universal Citation: 14 NY Comp Codes Rules and Regs ยง 588.10

Current through Register Vol. 46, No. 39, September 25, 2024

(a) Intensive psychiatric rehabilitation treatment visits shall be reimbursed on the basis of duration of hours provided as follows:

(1) Reimbursement shall be provided for visits of at least one hour in duration and not more than five hours per recipient per day.

(2) Reimbursement shall be provided for no more than 72 hours per recipient per month.

(3) Reimbursement shall be provided for no more than 720 hours per recipient per year.

(b) The utilization review authority designated pursuant to section 587.6 of this Title shall conduct the following reviews regarding, at a minimum, a random 25 percent sample of recipients:

(1) a review of the appropriateness of admission to an intensive psychiatric rehabilitation treatment program within 30 days after admission;

(2) a review of the need for continued treatment in an intensive psychiatric rehabilitation treatment program within four months after admission and every three months thereafter.

(c) The determination of need for admission to or continued treatment in an intensive psychiatric rehabilitation treatment program shall be reviewable by the Office of Mental Health or its designated agent.

(d) The referring licensed practitioner, in accordance with section 587.13(b) of this Title, or another licensed practitioner who is not affiliated with the intensive psychiatric rehabilitation treatment program, shall review the need for continued treatment four months after admission and quarterly thereafter. Such reviews shall be documented in the psychiatric rehabilitation service plan.

(e) The psychiatric rehabilitation service plan required pursuant to section 587.17 of this Title shall be completed within five visits after admission. Review of the service plan shall be every month.

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