Authorization and Rates for Specialized Mental Health Services. A. Payment may be requested for the services identified in this Agreement based on documented medical and service necessity and as authorized by the MHP, MHP designee or contractor if designated by the MHP.
B. Service authorization as determined by the MHP, MHP designee or contractor if designated by the MHP may change over the duration of treatment based on client needs. Contractor will not be reimbursed for unauthorized services. MHP will be responsible for service authorization and payment only for service months during which the consumer has Medi-Cal assigned to that MHP (County Code). If the MHP of beneficiary is changed during the course of treatment, authorization and payment responsibilities transfer to the new MHP of beneficiary.
C. Rate setting and payment shall be consistent with federal and state statute, regulations, and with the MHP contract. These rates are presently:
a) Mental Health Services $2.61 per minute b) Case Management, Brokerage $2.02 per minute c) Medication Support Services $4.82 per minute
d) Crisis Intervention per minute e) Crisis Stabilization per 4 hours
Authorization and Rates for Specialized Mental Health Services. A. Payment may be requested for the services identified in this Agreement based on documented medical and service necessity and as authorized by the MHP, MHP designee or Contractor if designated by the MHP.
B. Service authorization as determined by the MHP, MHP designee or Contractor if designated by the MHP may change over the duration of treatment based on client needs. Contractor will not be reimbursed for unauthorized services. MHP will be responsible for service authorization and payment only for service months during which the client has Medi-Cal assigned to that MHP (County Code). If the MHP of beneficiary is changed during the course of treatment, authorization and payment responsibilities transfer to the new MHP of beneficiary.
C. Rate setting and payment shall be consistent with federal and state statute, regulations, and with the MHP contract.
a) Mental Health Services b) Case Management, Brokerage c) Medication Support Services d) Crisis Intervention e) Therapeutic Behavioral Services
Authorization and Rates for Specialized Mental Health Services. Payment may be requested for the services identified in this Agreement based on documented medical and service necessity and as authorized by the MHP, MHP designee or contractor if designated by the MHP. Service authorization as determined by the MHP, MHP designee or contractor if designated by the MHP may change over the duration of treatment based on client needs. Contractor will not be reimbursed for unauthorized services. MHP will be responsible for service authorization and payment only for service months during which the consumer has Medi-Cal assigned to that MHP (County Code). If the MHP of beneficiary is changed during the course of treatment, authorization and payment responsibilities transfer to the new MHP of beneficiary. Rate setting and payment shall be consistent with federal and state statute, regulations, and with the MHP contract. These rates are presently: Mental Health Services _______________ per minute Case Management, Brokerage _______________ per minute Medication Support Services _______________ per minute Crisis Intervention _______________ per minute Crisis Stabilization _______________ per 4 hours Therapeutic Behavioral Services _______________ per minute Day Treatment Intensive – Half-Day _______________ per half-day Day Treatment Intensive – Full-Day _______________ per full-day Day Rehabilitation – Half-Day _______________ per half-day Day Rehabilitation – Full-Day _______________ per full-day Payment for services is subject to Medi-Cal documentation standards, establishment of medical necessity, and claim submissions consistent with State and Federal requirements. Contractor shall submit an Invoice within thirty (30) days for each consumer which details the units of service provided and payment rate, accompanied by the authorizing documents provided by MHP or designee. Contractor will cooperate with the MHP process for submitting the unit of service data for the MHP Medi-Cal billing process on the required timeline. A signed certification of claim shall be submitted with each Invoice. The MHP shall pay the Contractor consistent with the certified public expenditure process required by 42 CFR 433.51. If Cost Report Settlement is required, it shall be completed by the MHP within a reasonable timeline. Payment shall be required by MHP or Contractor within sixty (60) days of Settlement or as otherwise mutually agreed. Contractor shall comply with MHP, State, or Federal Fiscal or Quality Assurance Audits and repayment requirements...
Authorization and Rates for Specialized Mental Health Services. A. Payment may be requested for the services identified in this Agreement based on documented medical and service necessity and as authorized by the MHP, MHP designee or contractor if designated by the MHP.
B. Service authorization as determined by the MHP, MHP designee or contractor if designated by the MHP may change over the duration of treatment based on client needs. Contractor will not be reimbursed for unauthorized services. MHP will be responsible for service authorization and payment only for service months during which the consumer has Medi-Cal assigned to that MHP (County Code). If the MHP of beneficiary is changed during the course of treatment, authorization and payment responsibilities transfer to the new MHP of beneficiary.
C. Rate setting and payment shall be consistent with federal and state statute, regulations, and with the MHP contract. These rates are presently:
a) Mental Health Services b) Case Management, Brokerage per minute per minute c) Medication Support Services 4.82 per minute
d) Therapeutic Behavioral Services e) Day Rehabilitation – Full-Day per minute per full-day
Authorization and Rates for Specialized Mental Health Services. A. Payment may be requested for the services identified in this Contract based on documented medical and service necessity and as authorized by the MHP, MHP designee or contractor if designated by the MHP.
B. Service authorization as determined by the MHP, MHP designee or contractor if designated by the MHP may change over the duration of treatment based on client needs. Contractor shall not be reimbursed for unauthorized services. MHP will be responsible for service authorization and payment only for service months during which the consumer has Medi-Cal assigned to that MHP (County Code). If the MHP of beneficiary is changed during the course of treatment, authorization and payment responsibilities shall transfer to the new MHP of beneficiary.
C. Rate setting and payment shall be consistent with federal and state statute, regulations, and with the MHP contract for Medi-Cal billable services as follows: Program Provider type Hourly Rates Outpatient Psychiatrist/Contract Psychiatrist $ 1117.47 Outpatient Physician’s Assistant $ 501.18 Outpatient Nurse Practitioner $ 555.69 Outpatient RN $ 453.90 Outpatient Certified Nurse Specialist $ 555.69 Outpatient LVN $ 238.45 Outpatient Pharmacist $ 534.90 Outpatient Licensed Psychiatric Technician $ 204.41 Outpatient Psychologist/Pre-licensed Psychologist $ 449.41 Outpatient LPHA (MFT, LCSW, LPCC)/Intern or Waivered LPHA (MFT, LCSW, LPCC) $ 290.82 Outpatient Occupational Therapist $ 387.13 Outpatient Mental Health Rehab Specialist $ 218.80 Outpatient Peer Recovery Support $ 229.74 Outpatient Other Qualified Providers- Other Designated MH Staff that bill Medi-Cal $ 218.80
