PART I - Department of Behavioral Health and Developmental ...

Medication AdministrationClinicalOperationsServiceAccessibility1. Medication administration may not be billed for the provision of single or multiple doses of medication that a consumer has the ability to self-administer, eitherindependently or with supervision by a caregiver, either in a clinic or a community setting. In a group home/CCI setting, for example, medications may bemanaged by the house parents or residential care staff and kept locked up for safety reasons. Staff may hand out medication to the residents but this does notconstitute administration of medication for the purposes of this definition and, like other watchful oversight and monitoring functions, are not reimbursabletreatment services.2. If consumer/family requires training in skills needed in order to learn to manage his/her own medications and their safe self-administration and/or supervision ofself-administration, this skills training service can be provided via the Community Support or Family/Group Training services in accordance with the person’sindividualized recovery/resiliency plan.3. Foster parents are eligible for CSI or Family/Group Training in the supervision of medication self-administration by youth living in their care, but agencyemployees, including those working in residential settings such as group homes and CCIs, are not eligible for CSI or Family/Group Training in the supervision ofmedication self-administration by youth in their care.1. Medication Administration may not be provided in an Institution for Mental Diseases (IMD, e.g. state or private psychiatric hospital, psychiatric residentialtreatment facility or Crisis Stabilization Unit with greater than 16 beds), jail, youth development center (YDC) or prison system.2. This service may not be provided and billed for youth who are involuntarily detained in Regional Youth Detention Centers (RYDCs) awaiting criminal proceedings,penal dispositions, or other involuntary detainment proceedings. Any exception to this requires supporting documentation from the DJJ partners. The providerholds the risk for assuring the youth’s eligibility.Nursing Assessment and Health ServicesTransactionCodeCode Detail Code Mod1Mod2Mod3Mod4Rate Code Detail Code Mod1Mod2Mod3Mod4RateNursingAssessment/EvaluationRN Services, upto 15 minutesLPN Services,up to 15minutesPractitioner Level 2, In-Clinic T1001 U2 U6 $38.97 Practitioner Level 2, Out-of-Clinic T1001 U2 U7 $46.76Practitioner Level 3, In-Clinic T1001 U3 U6 $30.01 Practitioner Level 3, Out-of-Clinic T1001 U3 U7 $36.68Practitioner Level 4, In-Clinic T1001 U4 U6 $20.30 Practitioner Level 4, Out-of-Clinic T1001 U4 U7 $24.36Practitioner Level 2, In-Clinic T1002 U2 U6 $38.97 Practitioner Level 2, Out-of-Clinic T1002 U2 U7 $46.76Practitioner Level 3, In-Clinic T1002 U3 U6 $30.01 Practitioner Level 3, Out-of-Clinic T1002 U3 U7 $36.68Practitioner Level 4, In-Clinic T1003 U4 U6 $20.30 Practitioner Level 4, Out-of-Clinic T1003 U4 U7 $24.36FY2013 Provider Manual for Community Behavioral Health Providers Page 28