Sandhills Center announces service rate increases
Publication Date: October 26, 2016
Sand Sandhills Center has announced that it is increasing reimbursement rates to providers of community-based Intermediate Care Facilities, Evaluation and Management Coding, Outpatient Services, Psychological Testing and B-3 Individual Respite Care.
Sandhills Center is the organization responsible for public mental health, intellectual/developmental disabilities and substance abuse services in Anson, Guilford, Harnett, Hoke, Lee, Montgomery, Moore, Randolph and Richmond counties. This announcement continues Sandhills Center’s commitment to reinvesting 1915 (b)/(c) Medicaid Waiver savings into community-based services. The new reimbursement rates will begin with services offered on and following July 1, 2016.
- Community-Based Intermediate Care Facilities (ICFs) Community-based ICFs are a specialized residential option that provides care 24 hours a day, seven days a week, and treatment over an extended period of time for people with intellectual/developmental disabilities. The service offers support for them to live in their communities, promotes attainment of the highest level of independent living, and provides care for physical and medical needs. ICF services are comprehensive and individualized. Reimbursement rates for Community-Based ICF services will increase by 5 percent. (ICF services provided through state-operated facilities have an alternative reimbursement arrangement and, therefore, are not subject to the announced rate increase).
- Evaluation and Management Coding (E&M) E&M codes allow psychiatrists, nonpsychiatric physicians, physician assistants and nurse practitioners the ability to effectively plan and monitor integrated treatment around clinical history, examination and medical decision making. It also allows people to receive treatment based on their specific history with an assessment and clinical care plan based on their specific needs. Providers also have opportunities to be reimbursed for the amount of time they spend counseling the person, and for the amount of time they spend coordinating care for them. Reimbursement for E&M Codes will increase by 7 percent.
- Outpatient Services Community Outpatient Services are available to provide individuals with thorough assessments and high-quality treatment by licensed practitioners. Reimbursements for Outpatient Services will increase by 7 percent.
- Psychological Testing Psychological testing can involve a range of assessments and tools that allow psychologists to measure a person’s full range of strengths and limitations. The testing process aids in diagnostic clarification, intelligence and adaptive functioning, and in assisting with the determination of appropriate clinical services to inform the individual’s treatment plan. Psychological Testing (96101) will increase by 25 percent.
- B-3 Individual Respite Individual Respite services provide support for families and caregivers. These services are flexible, and can be planned in advance or provided on short notice. Respite services can occurr in a variety of settings including the individual’s own home. B-3 Individual Respite for both adults and youth (H0045HAU4 and H0045HBU4) will increase to $5 per 15-minute unit.
Sandhills Center manages the 1915 (b)/(c) Medicaid Waiver and is committed to a close partnership with a network of community providers who serve members with the right service to meet their individual needs. Additional opportunities for service reimbursement rate increases will be sought and announced to the provider network when available.