TO: ALL ADMINISTRATORS OF COMMUNITY PRIVATE ICFs/MR AND IDAHO STATE SCHOOL AND HOSPITAL
FROM: JOSEPH R. BRUNSON, Division Administrator
The Department has revised the guidelines for reporting and testing day treatment services performed for participants in a licensed Developmental Disability Center.
IDAPA 16.03.10.246.01.c states “When ICF/MR day treatment services are performed for patients in a licensed Developmental Disability Center, the allowable cost of such services shall be included in this category, but not more than the amount that would be paid according to the Department’s fee schedule for individual or group therapy for similar services. Amounts incurred or paid by the ICF/MR in excess of what would be paid according to the Department’s fee schedule for like services are not allowable costs and shall be reported as nonreimbursable.”
For cost reports ending on July 1, 2001 and after, the “Department’s fee schedule” mentioned above has been revised to five categories of therapy. The categories and procedure codes are as follows:
1. Developmental Therapy Individual – Center (8245A)
2. Developmental Therapy Group – Center (8250A)
3. Developmental Therapy Individual – Home/Community (8247A)
4. Developmental Therapy, Group of 2 – Home/Community (8248A)
5. Developmental Therapy, Group of 3 – Home/Community (8249A)
The applicable rates for each category will be the most recent rates published by Myers & Stauffer on behalf of the Department for affected providers.
The ICF/MR cost reporting form has been revised to allow the ICF/MR provider to report the five categories of therapy for which the ICF/MR provider is billed by a developmental disability center. The provider must record and report the total hours in each category by month on the revised cost reporting form. Myers & Stauffer will provide a copy of this form in a separate mailing.
Please direct any questions regarding this Information Release to Brett Ogata with Myers & Stauffer at (208) 378-1400 or 1-800-336-7721.
Thank you for your continued participation in Idaho Medicaid Program.