7 AAC 145.620 - Residential psychiatric treatment center payment rate
(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.
Notes
Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040
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