Common use of Billing for Treatment and Payment Restrictions Clause in Contracts

Billing for Treatment and Payment Restrictions. Grantees will; a. bill for only one intensity of service and service type (either outpatient or residential) per client per day b. not bill for an intensity of service and service type if another System Agency-funded Treatment Grantee is providing and billing System Agency for another intensity of service and service type. The following are the exception to item b.: A client may receive; a. co-occurring psychiatric / substance use disorder services, b. ambulatory detoxification, or c. opioid substitution therapy services, at the same time the client receives SUD outpatient or residential treatment services or items 1-3 listed above. If two Grantees provide services to the same client under this exception, the Grantees must coordinate services and both Grantees must document the service coordination in CMBHS.

Billing for Treatment and Payment Restrictions. Grantees will; a. bill A. Bill for only one intensity of service and service type (either outpatient or residential) per client per day b. not B. Not bill for an intensity of service and service type if another System Agency-funded Treatment Grantee is providing and billing System Agency for another intensity of service and service type. The following are the exception to item b.: A client may receive; a. i. co-occurring psychiatric / substance use disorder services, b. ii. ambulatory detoxification, or c. iii. opioid substitution therapy services, at the same time the client receives SUD outpatient or residential treatment services or items 1-3 listed above. If two Grantees provide services to the same client under this exception, the Grantees must coordinate services and both Grantees must document the service coordination in CMBHS.