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 588.8 - Standards pertaining to reimbursement for day treatment programs serving children

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

(a) Day treatment programs serving children shall receive reimbursement for the following types of visits:

(1) Full day visit: shall be reimbursed for services of at least five hours in duration.

(2) Half day visit: shall be reimbursed for services of at least three hours in duration but not more than five hours.

(3) Brief day visit: shall be reimbursed for services of at least one hour in duration but not more than three hours.

(4) Collateral visit: shall be reimbursed for services of at least 30 minutes in duration.

(5) Home visit: shall be reimbursed for services of at least 30 minutes in duration.

(6) Crisis visit: shall be reimbursed for services of at least 30 minutes in duration.

(7) Preadmission visit - full day: shall be reimbursed for services of at least five hours in duration.

(8) Preadmission visit - half day: shall be reimbursed for services of at least three hours in duration but not more than five hours.

(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 a day treatment program for children within 30 days after admission;

(2) a review of the need for continued treatment in a day treatment program for children within seven months after admission and every six months thereafter.

(c) The determination of need for admission to or continued treatment in a day treatment program for children shall be reviewable by the Office of Mental Health or its designated agent.

(d) The treatment plan required pursuant to section 587.16 of this Title shall be completed within 30 days of admission. Review of the treatment plan shall be every three months.

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