14 CRR-NY 512.20NY-CRR

STATE COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK
TITLE 14. DEPARTMENT OF MENTAL HYGIENE
CHAPTER XIII. OFFICE OF MENTAL HEALTH
PART 512. PERSONALIZED RECOVERY ORIENTED SERVICES
14 CRR-NY 512.20
14 CRR-NY 512.20
512.20 Target population services.
(a) Individuals who are target population members as defined in section 512.4 of this Part must meet the standard eligibility criteria for enrollment in PROS in accordance with section 512.7 of this Part.
(b) Effective April 1, 2014, the following additional provisions shall apply to PROS providers that are providing services to target population members.
(1) Reimbursement for services to target population members who are in continuous pre-admission status is limited to four consecutive months, whether or not the individual is ultimately admitted to the program. Programs will be reimbursed for pre-admission services for target population members at the existing pre-admission rate plus 25 percent.
(2) Medicaid may reimburse the Intensive Rehabilitation (IR) component add-on for up to 50 percent of a provider’s total number of monthly base rate bills submitted annually. IR services provided to target population members shall not count toward the 50 percent limitation for Medicaid reimbursement.
(3) The following Community Rehabilitation and Support (CRS) services will offer an enhanced reimbursement when delivered off site, on separate days, to target population members:
(i) basic skills living training;
(ii) benefits and financial management;
(iii) community living exploration;
(iv) information and education regarding self help; and
(v) wellness self management.
(4) If two or three of the identified CRS services are delivered off site to target population members in a calendar month, programs will be reimbursed at the base rate plus $135.33 (upstate) or $150.37 (downstate), effective April 1, 2015. If four or more of the identified CRS services are delivered off site to target population members in a calendar month, programs will be reimbursed at the base rate plus $270.67 (upstate) or $300.73 (downstate), effective April 1, 2015.
14 CRR-NY 512.20
Current through August 15, 2021
End of Document

IMPORTANT NOTE REGARDING CONTENT CURRENCY: JULY 31, 2023, is the date of the most recently produced official NYCRR supplement covering this rule section. For later updates to this section, if any, please: consult editions of the NYS Register published after this date; or contact the NYS Department of State Division of Admisnistrative Rules at [email protected]. See Help for additional information on the currency of this unofficial version of the NYS Rules.