Section He-M 426.23 - Payment(a) Medicaid payments shall be made for CMHP services rendered to recipients with both psychiatric and intellectual disability diagnoses for services related to the psychiatric diagnosis. Medical and billing records shall support this classification. The claim shall indicate the primary diagnosis related to the service rendered.(b) Community mental health services shall be paid at rates set by the department based on the audited costs of covered services as determined by units of services provided by all community mental health providers divided by the sum of costs for the individual's transportation, staff and staff related costs to provide such services incurred by all community mental health providers.(c) Claims for medicare-eligible medicaid recipients shall be submitted to medicare for all medicare covered services prior to submitting claims to medicaid.(d) Except for claims for people not eligible for medicaid, claims for service shall be submitted to the fiscal agent designated by the department.(e) Claims for services necessary to determine the appropriateness of nursing home referral, PASRR, for people who are not eligible for medicaid shall be submitted to: NH Department of Health and Human Services
Behavioral Health
PASRR Office
105 Pleasant Street
Concord, NH 03301
N.H. Admin. Code § He-M 426.23
#9285, eff 9-30-08 (from He-M 426.22 )
Amended by Volume XXXVI Number 41, Filed October 13, 2016, Proposed by #11182, Effective 9/29/2016, Expires 3/28/2017.Amended by Volume XXXVII Number 15, Filed April 13, 2017, Proposed by #12154, Effective 3/28/2017, Expires 3/28/2027.