37.87.1215 PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY SERVICES, ASSESSMENT SERVICES
(1) Psychiatric residential treatment facility (PRTF) assessment services are provided by in-state PRTF facilities and must comply with the requirements of this subchapter and the applicable federal regulations for PRTF services.
(2) PRTF assessment services:
(a) require prior authorization by the department or its designee;
(b) are short-term lengths of stay, 14 days or less;
(c) are reimbursed 15% higher than the department's current Medicaid Youth Mental Health Fee Schedule for PRTF Services.
(3) Assessment services include the following, as clinically indicated:
(a) diagnostic and functional assessment;
(b) medication evaluation;
(c) psychological and IQ testing;
(d) substance use disorder assessment; and
(e) supported group or independent living needs assessment.
(4) Assessment services include a written report within 14 days after the discharge that includes clear recommendations for treatment of the youth.
(5) If the PRTF admission continues beyond the assessment period and becomes a regular admission, the department will not reimburse at the higher rate for assessment services.
(a) If the youth is re-admitted to the facility within 30 days of the assessment, the admission for assessment may be subject to department review and full recovery.