Same Day Non-Contiguous Service Hours in a Chemical Dependence (CD) Outpatient Rehabilitation Program: In the following scenario, may service hours be added together to meet the full day CD outpatient rehabilitation requirement?
• The patient’s service needs exceed the level of services available in a Chemical Dependence Outpatient Clinic and therefore meet Part 822.9 admission criteria for an outpatient rehabilitation program. Specifically, the individual must have an inadequate social support system and either the individual has substantial deficits in functional skills or the individual has health care needs requiring attention or monitoring by health care staff. • An admitted patient receives Part 822 CD outpatient rehabilitation program services e.g., a scheduled a.m. group session. • The same patient leaves the program midday e.g., for a previously scheduled Dr’s appointment. • The patient then returns later that same day for an additional scheduled program services. • The scheduled morning and afternoon services total four hours. Answer: Yes. The program may bill the full day rehabilitation visit rate if the patient’s delivered daily cumulative program service hours meet or exceed the four hour full day
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