405 IAC 5-21.5-2 - Reimbursement
Authority: IC 12-15
Affected: IC 12-7-2-40.6; IC 12-13-7-3; IC 12-29
Sec. 2.
(a) The
office will reimburse MRO services for members who meet specific diagnosis and
level of need criteria under the approved DMHA assessment tool. The listing of
diagnostic and level of need criteria approved for reimbursement shall be as
follows:
(1) Will be listed and published in
a provider manual by the office.
(2) May be updated by the office as
needed.
(b) Services are
provided:
(1) through a behavioral health
service provider that is enrolled as a provider that offers a full continuum of
care as defined under IC
12-7-2-40.6 and 440 IAC 9; these
providers may subcontract for services as appropriate; and
(2) by personnel who meet appropriate
federal, state, and local regulations for their respective disciplines or are
under the supervision or direction of a licensed professional or
QBHP.
Notes
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No prior version found.