N.J. Admin. Code § 10:76-2.4

Current through Register Vol. 56, No. 24, December 18, 2024

Section 10:76-2.4 - PACT beneficiaries receiving other mental health services

(a) Partial care/partial hospitalization (PC/PH) services shall not be available, except if clinically indicated and recommended by the PACT team, for up to the last 30 days before a beneficiary terminates from PACT services. The PACT agency shall obtain prior authorization for services before enrolling a beneficiary in a PC/PH program. See N.J.A.C. 10:76-2.5.

(b) A PACT provider shall not request reimbursement for PACT services delivered during the same month the beneficiary is also receiving integrated case management services (ICMS).

(c) A PACT provider shall not request reimbursement for PACT services when the beneficiary is also receiving mental health rehabilitation services provided in/by community residence programs during the same month of service. (See N.J.A.C. 10:77 and 10:77A).

N.J. Admin. Code § 10:76-2.4

Amended by 48 N.J.R. 79(b), effective 1/4/2016