14 CRR-NY 822.6NY-CRR
14 CRR-NY 822.6
14 CRR-NY 822.6
822.6 Standards pertaining to Medicaid reimbursement.
(a) For purposes of Medicaid billing, a claim may be submitted for services delivered to a patient, collateral person, or significant other (regardless of whether such significant other is connected to a current patient with a diagnosed substance use disorder).
(b) Only services delivered by an office-certified or authorized program are eligible for Medicaid reimbursement under this Part.
(c) The content and/or outcome of all services must be fully documented in the patient’s case record consistent with section 822.11 of this Part.
(d) In order to qualify for reimbursement, each service must be documented as a covered Medicaid service in accordance with the following:
(1) the service must meet the standards established in this Part;
(2) the service must meet the standards established in Part 841 of this Title;
(3) the service must be provided by appropriate staff as required in this Part.
(e) The following services alone do not constitute a service eligible for Medicaid reimbursement:
(1) nutrition services;
(2) educational and vocational services;
(3) recreational and social activity services;
(4) group meetings, workshops or seminars that are primarily informational or organizational;
(5) acupuncture;
14 CRR-NY 822.6
Current through May 31, 2021
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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.