Title 907 | Chapter 015 | Regulation 075


907 KAR 15:075.Reimbursement provisions and requirements for behavioral health services provided by residential crisis stabilization units.

Section 1.

General Requirements. For the department to reimburse for a service covered under this administrative regulation, the service shall be:

(1)

Medically necessary;

(2)

Provided:

(a)

To a recipient;

(b)

By a residential crisis stabilization unit that meets the provider participation requirements established in 907 KAR 15:070; and

(c)

In accordance with the requirements established in 907 KAR 15:070; and

(3)

Covered in accordance with 907 KAR 15:070.

Section 2.

Reimbursement.

(1)

The department shall reimburse a per diem rate of $354 for services provided by a residential crisis stabilization unit to a recipient for a day.

(2)

The reimbursement referenced in subsection (1) of this section shall represent total reimbursement for all services provided by a residential crisis stabilization unit to a recipient for the day.

Section 3.

Not Applicable to Managed Care Organizations. A managed care organization shall not be required to reimburse in accordance with this administrative regulation for a service covered pursuant to:

(1)

907 KAR 15:070; and

(2)

This administrative regulation.

Section 4.

Federal Approval and Federal Financial Participation. The department's reimbursement for services pursuant to this administrative regulation shall be contingent upon:

(1)

Receipt of federal financial participation for the reimbursement; and

(2)

Centers for Medicare and Medicaid Services' approval for the reimbursement.

HISTORY: (41 Ky.R. 970; Am. 1807; eff. 3-6-2015.)

7-Year Expiration: 3/6/2022

Last Updated: 12/15/2021


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