Regulation .06 Fee Schedule — Additional Treatment Services.
Regulation .06 Fee Schedule — Additional Treatment Services.LinkCopy Citation
A.
Psychological Testing. The Department shall reimburse a psychologist for conducting psychological testing, up to a maximum of 8 hours per year per individual as follows:
(1)
OMHC psychologist ... $99.02 per hour;
(2)
Other psychologist ... $99.02 per hour;
(3)
OMHC psychologist associate ... $27.55 per hour;
(4)
Other psychologist associate ... $27.55 per hour.
B.
Occupational Therapy. The Department shall reimburse an occupational therapist for providing services, as follows:
(1)
To an individual, payable in 15-minute increments, for face-to-face:
(a)
Therapeutic activities ... $11.83 per 15 minutes;
(b)
Self-care, home management training ... $11.83 per 15 minutes;
(c)
Community and work reintegration ... $11.83 per 15 minutes;
(d)
Development of cognitive skills ... $11.83 per 15 minutes;
(e)
Occupational therapy evaluation and re-evaluation ... $15.07 per 15 minutes;
(2)
For each individual, up to a maximum of 10, in a group therapy session of a minimum of 60 minutes ... $18.30.
C.
Physician Services. The Department shall reimburse for services rendered to a child, adolescent, or adult, by an appropriately privileged physician or certified registered nurse practitioner — psychiatric only, as follows:
(1)
The patient's primary care physician in an inpatient or partial hospital setting:
(a)
Initial care:
(i)
For a minimum of 30 minutes ... $108.43;
(ii)
For a minimum of 50 minutes ... $147.19;
(iii)
For a minimum of 70 minutes ... $216.47;
(b)
Subsequent care:
(i)
For a minimum of 15 minutes ... $41.71;
(ii)
For a minimum of 25 minutes ... $76.73;
(iii)
For a minimum of 35 minutes ... $110.63;
(c)
Discharge day management:
(i)
For 30 minutes or less ... $77.68;
(ii)
For more than 30 minutes ... $114.63;
(d)
For discharge data submission ... $21.53;
(e)
For individual therapy, in an inpatient setting:
(i)
For 30 minutes ... $43.78;
(ii)
For 45 minutes ... $82.30;
(2)
The patient's primary certified registered nurse practitioner — psychiatric, in an inpatient or partial hospital setting:
(a)
Initial care:
(i)
For a minimum of 30 minutes ... $108.43;
(ii)
For a minimum of 50 minutes ... $147.19;
(iii)
For a minimum of 70 minutes ... $216.47;
(b)
Subsequent care:
(i)
For a minimum of 15 minutes ... $41.71;
(ii)
For a minimum of 25 minutes ... $76.73;
(iii)
For a minimum of 35 minutes ... $110.63;
(c)
Discharge day management:
(i)
For 30 minutes or less ... $77.68;
(ii)
For more than 30 minutes ... $114.63;
(d)
For individual therapy, in an inpatient setting:
(i)
For 30 minutes ... $30.65;
(ii)
For 45 minutes ... $57.61;
(3)
For electroconvulsive therapy, in an inpatient setting:
(a)
Including monitoring ... $98.39;
(b)
Anesthesia ... $98.27;
(4)
A consultant physician, or a consultant certified registered nurse practitioner — psychiatric, in an inpatient or partial hospital setting, initial consult, for a minimum of:
(a)
20 minutes ... $51.66;
(b)
40 minutes ... $79.60;
(c)
55 minutes ... $121.30;
(d)
80 minutes ... $174.86;
(e)
110 minutes ... $217.80;
(5)
A consultant physician or a consultant certified registered nurse practitioner — psychiatric, in an outpatient setting:
(a)
For a minimum of 15 minutes ... $51.49;
(b)
For a minimum of 30 minutes ... $96.74;
(c)
For a minimum of 40 minutes ... $131.91;
(d)
For a minimum of 60 minutes ... $194.98;
(e)
For a minimum of 80 minutes ... $237.73;