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MEDICAID INFORMATION RELEASE MA06-25

posted on March 02, 2009 12:18

July 7, 2006

MEDICAID INFORMATION RELEASE MA06-25

TO: Developmental Disability Centers (DD), Mental Health Clinic (MHC) and

Mental Health Rehabilitation (MHR) Providers

FROM: Leslie M. Clement, Administrator

SUBJECT: CHANGES TO MEDICAID REIMBURSEMENT RATES

Effective July 1, 2006, the following table reflects increases to reimbursement rates for the following services:

Provider	HCPCS Code	Modifier	Description	New Rate
DD	97003		OCCUPATIONAL THERAPY EVALUATION -1 UNIT= 15 MIN	$14.00
DD	97535	HQ	OCCUPATIONAL THERAPY/GROUP -1 UNIT= 15 MIN	$3.59
DD	97535		OCCUPATIONAL THERAPY-INDIVIDUAL -1 UNIT= 15MIN.	$14.00
DD	97001		PHYSICAL THERAPY EVALUATION -1 UNIT= 15 MIN	$14.00
DD	97150		PHYSICAL THERAPY GROUP -1 UNIT= 15 MIN	$3.59
DD	97110		PHYSICAL THERAPY INDIVIDUAL -1 UNIT=15 MIN	$14.00
DD	90801		PSYCHIATRIC DIAGNOSTIC INTERVIEW EXAM, 1 UNIT = 15 MIN	$16.46
DD	90847	U4	PSYCHOTHERAPY FAMILY FOR NF RECIPIENT; 1 UNIT=15 MIN	$12.84
DD	90847		PSYCHOTHERAPY FAMILY MEDICAL 1 UNIT = 15 MIN	$12.84
DD	90853		PSYCHOTHERAPY GROUP MEDICAL 1 UNIT = 15 MIN	$3.89
DD	H0004		PSYCHOTHERAPY INDIVIDUAL MEDICAL , 1 UNIT = 15 MIN	$14.35
DD	92506		SPEECH EVALUATION -1 UNIT= 15 MIN	$14.00
DD	92508		SPEECH THERAPY GROUP -1 UNIT= 15 MIN	$4.37
DD	92507		SPEECH THERAPY INDIVIDUAL -1 UNIT=15 MIN	$14.00
MHC	97535		OCCUPATIONAL THERAPY - INDIVIDUAL - 1 UNIT= 15 MIN	$14.00
MHC	90847	U4	PSYCHOTHERAPY FAMILY FOR NF RECIPIENT;1 UNIT = 15 MIN	$12.84
MHC	90899	U4	PSYCHOTHERAPY INDIVIDUAL INTERACTIVE NF RECIPIENT 1 UNIT=15	$16.74
MHR	97003		OCCUPATIONAL THERAPY EVALUATION 1 UNIT = 15 MIN	$14.00
MHR	97535		OCCUPATIONAL THERAPY-INDIVIDUAL -1 UNIT= 15MIN.	$14.00
MHR	90847		PSYCHOTHERAPY FAMILY	$12.84
MHR	90847	U4	PSYCHOTHERAPY FAMILY FOR NF RECIPIENT; 1 UNIT=15 MIN	$12.84
MHR	H0004	U4	PSYCHOTHERAPY INDIVIDUAL FOR NF RECIPIENT; 1 UNIT = 15 MIN	$12.84

These rates are being adjusted in order to bring them into alignment with rates paid to other community-based providers. If the market analysis results show that payment increases were not warranted, the Department may make additional changes to these reimbursement rates to reflect the results of the market analysis.

If you have any questions please contact Gynna Loper, Senior Financial Specialist in the Office of Medicaid Reimbursement Policy, at (208) 364-1994.

Thank you for your continued participation in the Idaho Medicaid program.

LMC/gl/sw

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