New York Codes, Rules and Regulations
Title 14 - DEPARTMENT OF MENTAL HYGIENE
Chapter XXI - OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES
Part 822 - General Service Standards for Substance Use Disorder Outpatient Programs
Section 822.6 - Standards pertaining to Medicaid reimbursement

Universal Citation: 14 NY Comp Codes Rules and Regs ยง 822.6

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

(a) For purposes of Medicaid billing, a claim may be submitted for services delivered to a patient, collateral person, or significant other (regardless of whether such significant other is connected to a current patient with a diagnosed substance use disorder).

(b) Only services delivered by an Office-certified or authorized program are eligible for Medicaid reimbursement under this Part.

(c) The content and/or outcome of all services must be fully documented in the patient record consistent with this Part.

(d) In order to qualify for reimbursement, each service must be documented as a covered Medicaid service in accordance with the following:

(1) the service must meet the standards established in this Part;

(2) the service must meet the standards established in Part 841 of this Title;

(3) the service must be provided by appropriate staff as required in this Part.

(e) The following services alone do not constitute a service eligible for Medicaid reimbursement:

(1) nutrition services;

(2) educational and vocational services;

(3) recreational and social activity services;

(4) group meetings, workshops or seminars that are primarily informational or organizational;

(5) acupuncture.

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