Regulation .05 Covered Services.
Regulation .05 Covered Services.LinkCopy Citation
A.
The Program reimburses for completed comprehensive evaluations, which include assessment by a nurse, social worker, or both.
B.
The comprehensive evaluation or designated form is to be completed within the following time frames:
(1)
3 business days for all Geriatric Evaluation Services (GES) and Preadmission Screening and Resident Review (PASRR) for individuals transferring from a hospital to a nursing facility;
(2)
5 business days for all other PASRR; and
(3)
15 calendar days for all other purposes.
C.
The comprehensive evaluation shall be completed in-person.
D.
The Department will reimburse for the services listed in §A of this regulation when they are:
(1)
Rendered to participants as defined in Regulation .02 of this chapter;
(2)
Completed within the time frame specified in §B of this regulation, unless the Department is notified, in writing, of circumstances that prevent completion within the specified time frame and a temporary, alternative schedule has been approved by the Department;
(3)
Adequately performed as reflected on the completed form specified by the Department and submitted to the Program as a condition for payment; and
(4)
Rendered by a provider approved to perform comprehensive evaluations.