New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIV - Office for People With Developmental Disabilities › Part 635 - General Quality Control and Administrative Requirements Applicable to Programs, services or Facilities Funded or Certified by the Office for People With Developmental Disabilities › Subpart 635-12 - Liability for Services › Section 635-12.9 - Fee schedules

Current through Register Vol. 46, No. 28, July 10, 2024
(a) This
				  section applies to all services, whether or not they are preexisting
				  services.
(b) For community
				  residential habilitation services (delivered in a community residence which is
				  not an individualized residential alternative [IRA]), the fee shall equal the
				  Medicaid fee OPWDD established for the community residential habilitation
				  services for the dates the services were provided.
(c) For residential habilitation services
				  provided in an IRA, the fee shall equal the Medicaid price OPWDD established
				  for the IRA residential habilitation services for the dates the services were
				  provided.
(d) For residential
				  habilitation services provided in a family care home, the fee shall equal the
				  Medicaid price OPWDD established for the family care residential habilitation
				  services for the dates the services were provided.
(e) For at home residential habilitation
				  services, the fee shall equal the Medicaid fee OPWDD established for the at
				  home residential habilitation services for the dates the services were
				  provided.
(f) For day treatment
				  services, the fee shall equal the Medicaid fee OPWDD established for the day
				  treatment facility for the dates the services were provided.
(g) For an ICF/DD, the fee shall equal the
				  Medicaid rate OPWDD established for the ICF/DD for the dates the services were
				  provided, excluding any day program services add-on for education and related
				  services in accordance with Title 8 NYCRR.
(h) For day habilitation services, the fee
				  shall equal the Medicaid price OPWDD established for the day habilitation
				  services for the dates the services were provided.
(i) For Medicaid service coordination, the
				  fee shall equal the payment level applicable to the individual's situation as
				  stated in the Medicaid service coordination vendor contract between the
				  provider and OPWDD in effect on the dates the services were provided.
(j) For prevocational services, the fee shall
				  equal the Medicaid price OPWDD established for the prevocational services on
				  the dates the services were provided.
(k) For supported employment services, the
				  fee shall equal the Medicaid fee OPWDD established for the supported employment
				  services for the dates the services were provided.
(l) For respite services, the fee shall equal
				  the Medicaid price OPWDD established for the respite services for the dates the
				  services were provided.
(m) For
				  blended or comprehensive services, the fee shall equal the price OPWDD
				  established for the blended or comprehensive services for the dates the
				  services were provided.
(n) For
				  hourly community habilitation services, the fee shall equal the Medicaid fee
				  OPWDD established for the hourly community habilitation services for the dates
				  the services were provided.
(o) For
				  community habilitation phase II services, the price shall equal the Medicaid
				  fee OPWDD established for community habilitation phase II services for the
				  dates the services were provided.