Reimbursement is based on the lesser of the billed amount or the Title XIX (Medicaid) maximum allowable for each procedure.

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 is eligible for Medicaid prior to rendering services.

Children's Services targeted case management services must be billed on a per unit basis. One case management unit is the sum of all Children's Services targeted case management activities that occur within a day.