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Sandhills Center announces service rate increases

Sandhills Center announces service rate increases

Publication Date: June 28, 2017

Sandhills Center recently announced that it will increase reimbursement rates to providers of community-based Intermediate Care Facilities and selected Innovations Services. Sandhills Center is the Local Management Entity-Managed Care Organization (LME-MCO) for mental health, intellectual/developmental disabilities and substance abuse services in Anson, Guilford, Harnett, Hoke, Lee, Montgomery, Moore, Randolph and Richmond counties in central North Carolina.

This announcement continues Sandhills Center’s commitment to reinvesting 1915 (b)/(c) Medicaid Waiver savings into community-based services. These new rates begin with services offered on and following July 1.

Community-Based Intermediate Care Facilities (ICFs) — These are residential options that provide care 24 hours a day, seven days per week, and treatment over an extended period of time for people with intellectual/developmental disabilities. The service offers support for individuals to live in their communities, promotes attainment of the highest level of independent living, and provides care for physical and medical needs. Reimbursement rates have increased by 6 percent. ICF services provided through state-operated facilities have an alternative reimbursement arrangement and are therefore not subject to the announced increase.

Innovations Services — These services are available to participants of the North Carolina Innovations Waiver, a funding resource offering supports and services to individuals with intellectual/developmental disabilities who are at risk for institutional care in an Intermediate Care Facility. For individuals who have received an Innovations funding slot through this Medicaid Home and Community-Based Services Waiver – an array of community-based services and supports that promote choice, control and community integration — are available as an alternative to institutional care. These services include supports designed to meet individuals’ physical and/or medical needs. The following Innovations services will be increased by the amounts indicated for all dates of service on and after July 1:

Procedure Code Modifier Service Description Billing Unit July 1, 2017 Rate Percentage Increase
T2013 TF Community Living and Support – Individual 15 minutes $5.18 10%
T2041 Community Guide Monthly $150.00 14%

 

Sandhills Center is dedicated to working with community partners within the region to improve access and availability of high-quality behavioral health services. We will continue to explore opportunities to make adjustments to services, reimbursement rates and service-delivery models to more effectively meet individuals’ identified needs.