La. Admin. Code tit. 50 § XXXIII-12303

Current through Register Vol. 50, No. 11, November 20, 2024

Section XXXIII-12303 - Covered Services

A. The Medicaid Program may reimburse a therapeutic group home for the following services:

1. screening and assessment services;

2. therapy services (individual, group, and family whenever possible);

3. on-going psychiatric assessment and intervention as needed; and

4. skill-building services.

B. Service Exclusions. The following services/components shall be excluded from Medicaid reimbursement:

1. components that are not provided to, or directed exclusively toward the treatment of, the Medicaid eligible individual;

2. services provided at a work site which are job tasks oriented and not directly related to the treatment of the recipient's needs;

3. any services or components in which the basic nature of which are to supplant housekeeping, homemaking, or basic services for the convenience of an individual receiving services;

4. services rendered in an institution for mental disease;

5. room and board; and

6. supervision associated with the child's stay in the TGH.

La. Admin. Code tit. 50, § XXXIII-12303

Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 38:428 (February 2012), Amended by the Department of Health and Hospitals, Bureau of Health Services Financing and the Office of Behavioral Health, LR 412371 (11/1/2015), Amended by the Department of Health, Bureau of Health Services Financing and the Office of Behavioral Health, LR 441904 (10/1/2018).

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.