Reimbursement is based on the actual cost of rehabilitative services billed and approved for payment. For residential based services, the daily cost for room and board is deducted to determine net reimbursable costs.

Reimbursement is contingent upon eligibility of both the recipient and provider at the time the service is provided and upon accurate completeness of the claim filed for the service. The provider is responsible for verifying the recipient's eligibility for Medicaid prior to rendering services.

Non-residential rehabilitative services for youth and children must be billed on a per unit basis. One unit equals 15 minutes unless otherwise stated in the Billing Procedures section of this manual.

One (1) unit = 5 - 15 minutes

Two (2) units = 16 - 30 minutes

Three (3) units = 31 - 45 minutes

Four (4) units = 46 - 60 minutes

Providers may bill the total units of service for a single date of service but may not bill the total units of service for spanning dates of service. For example, a qualified professional may provide therapy services to an eligible youth on Monday and then again on Tuesday. The Rehabilitative Services for Youth and Children provider may bill for the total amount of time spent on Monday and a separate total amount of time spent on Tuesday, but may not bill for the total amount of time spent both days as a single date of service.

Residential rehabilitative services must be billed on a daily basis. For residential services, one unit equals one day of service. Providers may collectively bill services up to one calendar month. For example, a rehabilitative services provider of residential treatment that serves an eligible youth for the entire month of July may bill the entire month as July 1 through July 31, for a total of 31 days of service or 31 units.