(a) Qualified providers. Payments are made to qualified
providers delivering a Level II evaluation to determine if a person
believed to have a mental illness (MI) or an intellectual or developmental
disability (IDD) requires the level of care provided by a nursing
facility (NF) and, if so, whether the person needs specialized services
for their MI or IDD according to the program rules as defined in 40
TAC Chapter 17 (relating to Preadmission Screening and Resident Review).
(b) Unit of service. Qualified providers are reimbursed
based on a 15-minute unit of service for a PASRR Level II evaluation.
(c) Reimbursement methodology.
(1) The Health and Human Services Commission determines
the PASRR Level II evaluation rate based on the salary cost for a
qualified provider and other statistical data on providers delivering
similar services.
(2) The reimbursement methodology for a PASRR Level
II evaluation is also governed by: §355.108 of this chapter (relating
to Determination of Inflation Indices); §355.109 of this chapter
(relating to Adjusting Reimbursement When New Legislation, Regulations,
or Economic Factors Affect Costs); and §355.110 of this chapter
(relating to Informal Reviews and Formal Appeals).
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