AOD Billable Services.xlsx
Transcrição
AOD Billable Services.xlsx
DRAFT: Substance Use Services Reimbursement Matrix FY 2013/14 Rates* Medi-Cal Eligible (Currently Eligible - Services/Rates Prior to January 1, 2014 ACA) D/MC Coverage PHC Coverage Rate (DMC/ PHC) Engage/Pre-Treatment Readiness No Assessment Outpatient Treatment No Yes (6 sessions/ episode: 60-90 min) NA/$40.00 Individual (50 minutes) Yes (Generally Limited to Treatment Planning, Discharge, Crisis) Yes (20 sessions/rolling year) Yes (Peri DMC is up to 60 days postpartum) Yes (48 sessions/rolling year) CMSP/Path2Health Eligible Coverage Un/Under-Insured (County AOD subsidized) Rate Coverage Rate Outreach, Engagement and Assessment Peri Individual (50 minutes) Group (90 minutes) Peri Group (50 minutes) IOP Group (3 hours) Peri IOP Group (3 hours) Residential Treatment Residential Peri Residential No Yes (Up to 60 days post-partum) No Yes (Up to 60 days postpartum/episode) Medication Assisted Treatment Methadone (Daily Dose) Yes Methadone (Ind. Couns.-10 min.) Yes Peri Methadone (Daily Dose) Yes Peri Methadone (Ind Coun.-10 min) Yes Detoxification Detox: Short-Term Residential No Other: Continuous Recovery/Care Management/Family $72.32/$50.00 No NA Varies by Contract Varies by Contract Yes (1 session/CY) $90.00 RCC Only $70.00/hour $103.52/$50.00 $29.39/$35.00 $62.24/$35.00 NA/$66.00 Yes (2 sessions/ calendar year) $17.50/15-minutes, up to $70.00/60 minutes) Yes $70.00 Yes (20 sessions/ calendar year) $30.00 Yes $32.00 No NA Yes $75.00 $79.39/$81.00 No NA Yes $75.00 No No NA Yes $95.00 $97.72/$71.00 No NA Yes $140.00 No No No No $11.49/NA $14.46/NA $12.57/NA $20.70/NA No No No No NA NA NA NA Yes Yes Yes Yes $5.21 $8.18 $5.21 $8.18 No NA/NA No NA Yes $160.00 Yes (14 sessions/episode) Yes (61 days post-partum or if D/MC benefits are exhausted, up to 14 sessions/episode) No Yes (61 days post-partum, up to 30 days/episode) Continuous Recovery No Yes (up to 3- 60 to 90 minute sessions/ week, up to 20 sessions/episode) NA/$33.00 No NA No NA Care Management No No NA/NA No NA $55.00 No Yes (1- 60 to 120 minute session/week up to 4 sessions/episode; excludes client participation) RCC and Grant-Funded Only NA/$40.00 No NA No NA Family and Codependency *Note: The Drug/Medi‐Cal rates are the proposed FY 2013/14 rates. The CMSP/Path2Health and PHC rates are from FY 2012 and updated rates will be provided when available.