New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 588 - Medical Assistance Payment For Outpatient Programs › Section 588.6 - Standards pertaining to reimbursement for clinic treatment programs

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Clinic
				treatment programs shall receive reimbursement for the following types of
				visits:
(1) Brief visit: shall be reimbursed
				for services of at least 15 minutes in duration but not more than 29 minutes of
				face-to-face interaction between one recipient and one therapist.
(2) Regular visit: shall be reimbursed for
				services of at least 30 minutes in duration of face-to-face interaction between
				one recipient and one therapist.
(3) Crisis visit: shall be reimbursed for
				services of at least 30 minutes in duration of face-to-face interaction between
				one recipient and one therapist.
(4) Group therapy visits: shall be reimbursed
				for services of at least 60 minutes duration provided to from 2 to 12
				recipients and a therapist(s).
(5)
				Collateral visit: shall be reimbursed for:
(i)
				clinical support services of at least 30 minutes in duration of face-to-face
				interaction between one or more collaterals and one therapist with or without a
				recipient; or
(ii) family treatment
				services of at least 30 minutes in duration of face-to-face interaction among
				all of the following: a recipient, one or more family members, and a
				therapist.
(6) Group
				collateral visit: shall be reimbursed for:
(i)
				clinical support services, as defined in section
				587.4(c)(5) 
				of this Title, of at least 60 minutes in duration but not more than two hours
				and shall represent services to more than one recipient and/or his or her
				collaterals. Such visits need not include recipients but shall not include more
				than 12 collaterals and/or recipients in a face-to-face interaction with a
				therapist for which reimbursement is claimed. Such limitation does not preclude
				the non-reimbursed participation of additional persons in the group session but
				such participation shall not be separately reimbursed; or
(ii) family treatment services of at least 60
				minutes in duration but not more than two hours and shall include services to
				more than one recipient. For each recipient participant, at least one family
				member shall participate. However, only one group collateral bill per recipient
				is allowed per day. Such visits shall not include more than 12 participants,
				including recipients and family members, for which reimbursement is claimed.
				Such limitation does not preclude the non-reimbursed participation of
				additional persons in the group session.
(7) Family visit: Shall be reimbursed for
				family treatment services, as defined in section
				587.4(c) 
				of this Title, of at least 60 minutes in duration of face-to-face interaction
				between one recipient, one or more of his or her family members, and one
				therapist. For purposes of billing family visits which meet these criteria,
				providers shall bill one regular visit and one collateral visit.