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UPDATE:  Provider Financial Stabilization Program for Child MH/SUD Residential and PRTF Services

UPDATE:  Provider Financial Stabilization Program for Child MH/SUD Residential and PRTF Services.

Due to the COVID outbreak, Alliance Health is committed to providing financial support for our Medicaid funded Child Residential Services. The rates are specifically to support direct care staff and families, increased expenses to meet children’s’ education and nutrition needs during extended school closure and COVID related supplies. Each level of service  has a Scope of Work to clarify those expectations.

Alliance is extending the date of the rate enhancement thru June 30, 2020 for the Child MH/SUD Residential and PRTF services. The table below outlines the rate increase per level of care along with the associated procedure codes.

CODE TABLE
Level of CareProcedure CodeCOVID 90 Day Rate Increase
PRTFRC 91115%(based on provider rate)
Therapeutic Foster Care, IAFT, Enhanced TFC, IDD/MH TFCS5145

S5145 22 HA
S5145 22 Z1
S5145 22 Z2

$109.49

 

$218.28

$131.75

$222.00

 

Level IIH2020$151.57
Level III & IVH0019 HK
H0019 HQ
H0019 TJ
$378.85

$279.46

$227.70

Rapid ResponseS5145 22 Z3$260.00

 

Important Information regarding State Funded Residential providers

Due to the COVID outbreak, Alliance Health is committed to providing financial support for our State Funded Residential Services. The rates are specifically to support direct care staff and increased facility related costs due to COVID. These rates are in effect from June 1-June 30, 2020.

There are some State Funded specialized residential services that are not included in the grid below, but will be notified individually for their program specific enhanced rate. Individual agencies impacted by those exceptions will be notified by their Provider Network Development Specialist.

CODE TABLE
Level of CareProcedure CodeJune Rate

 

Group Living HighYP780$162.74
Group Living ModerateYP770$86.80
Group Living LowYP760$63.58
Family Living LowYP740$57.50
Supervised Living LowYP710$33.26
Supervised Living-2YM812$186.29

 

Update on Telephonic Codes

The below telephonic codes will be extended through the conclusion of the State of Emergency related to COVID-19. Please note, Alliance is currently working through the setup of extending the below COVID-19 related codes and we will issue further guidance thru Provider News on when you can successfully submit billing, please continue to hold billing until this notice is issued.

Procedure CodeDescription
99441 CRPHONE E/M PHYS/QHP 5-10 MI
99442 CRPHONE E/M PHYS/QHP 11-20 MIN
99443 CRPHONE E/M PHYS/QHP 21-30 MIN
98966 CRPHONE E/M NON-PHYS QHP 5-10 MIN
98967 CRPHONE E/M NON-PHYS QHP 11-20 MI
98968 CRPHONE E/M NON-PHYS QHP 21-30 MIN
99446 CRINTERPROFESSIONAL CONSULTATIONS QHP TO MD 5-10 MIN
99447 CRINTERPROFESSIONAL CONSULTATIONS QHP TO MD 11-20 MIN
99448 CRINTERPROFESSIONAL CONSULTATIONS QHP TO MD 21-30 MIN
99449 CRINTERPROFESSIONAL CONSULTATIONS QHP TO MD 31 + MIN

 

Important Information for Innovation, TBI and IDD Providers

The Division of Health Benefits (NC Medicaid) issued Special Bulletins COVID-19 #75 & 76   Behavioral Health Service Flexibilities– Innovations and TBI Waivers’ Appendix K and Developmental Disability State Funded Benefit Plans. Please note, Alliance is currently working through the setup of using COVID-19 related GT and CR modifiers and we will issue further clarification and guidance by the end of next week to identify effective date to submit billing using these modifiers.

https://medicaid.ncdhhs.gov/blog/2020/05/01/special-bulletin-covid-19-75-telehealth-and-virtual-patient-communications-clinical

https://medicaid.ncdhhs.gov/blog/2020/05/01/special-bulletin-covid-19-76-telehealth-and-virtual-patient-communications-clinical

 


Please direct any questions or concerns to: [email protected].

Alliance Health highly recommends that you monitor Provider News and our website daily for any updates regarding provider services. Alliance will update this information as we receive any updates from the State in regards to COVID-19.

Please continue to check our COVID-19 resources for providers at alliancehealthplan.org/providers/covid-19-updates-and-resources. Alliance will continue to update this page with resources.

In the event that COVID -19 seriously impacts your ability to provide services to our members, please notify Alliance immediately by submitting the Temporary Disruption of Service Delivery form found on our website.

 



Page last modified: June 1, 2020