23 Miss. Code. R. 223-6.5 - Reimbursement
A. The Division of
Medicaid reimburses expanded rehabilitative services based on a statewide
uniform fee schedule.
B. The
Division of Medicaid does not reimburse for the duplication of services.
1. Providers are responsible for coordinating
services with the beneficiary and guardian/legal representative to avoid
service duplication when the beneficiary is receiving mental health services at
more than one (1) location from more than one (1) provider.
2. When duplicate service claims are filed
the provider billing the first claim is reimbursed.
C. The Division of Medicaid reimburses a
monthly fee for medically necessary wraparound facilitation as part of a
targeted case management benefit for EPSDT-eligible beneficiaries with a
serious emotional disturbance (SED) that meet the level of care provided in a
psychiatric residential treatment facility (PRTF).
D. The Division of Medicaid reimburses an
hourly rate and additional time in fifteen (15) minute units for Mississippi
Youth Program Around the Clock (MYPAC) Therapeutic Services.
1. Beneficiaries must be provided a choice of
the following:
a) MYPAC therapeutic services
or individual therapeutic services,
b) The provider of the services and
c) The team members included in service
planning.
2. The
Division of Medicaid does not reimburse for services included in MYPAC
Therapeutic Services individually during the time period the beneficiary has
chosen to receive MYPAC Therapeutic Services.
3. Service provision must, at a minimum, be
one (1) hour per day to be reimbursed for the services.
a) The initial hour must be billed as four
(4) fifteen (15) minute units.
b)
After the initial hour, fifteen (15) minute units may be billed based on actual
time of service provision as medically necessary and with appropriate
documentation.
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.