Section He-W 568.10 - Payment for Services(a) Reimbursement to providers of physical therapy, occupational therapy and services for individuals with speech, hearing and language disorders shall be made in accordance with fee schedules established by the department, in accordance with RSA 161:4, VI(a).(b) The provider shall bill with a therapy procedure code as defined by the American Medicaid Association's "Current Procedural Terminology (CPT) 2022 Professional Edition" available as noted in Appendix A, and submit claims for payment to the department's fiscal agent.(c) The provider shall maintain supporting records, in accordance with He-W 520 and He-W 568.08.(d) Providers shall submit claims for payment for services in accordance with the following: (1) Only direct treatment by a therapist or a physical therapy assistant, occupational therapy assistant, or speech-language assistant shall be billed, meaning the time the therapist or physical therapy assistant, occupational therapy assistant, or speech-language assistant spends providing direct treatment to one recipient;(2) Therapists working as a team to treat one or more recipients shall not each bill separately for the same or different service provided at the same time to the same recipient; and(3) If a recipient requires co-treatment simultaneously by 2 therapists, visits shall be billed separately by each provider for the total time the recipient was receiving actual therapy services.(e) The time a recipient spends not being treated, for any reason, shall not be billed.(f) Services provided by a physical therapy assistant, occupational therapy assistant, or speech-language assistant, in accordance with He-W 568.05(b) and (c) above, shall be billed by the enrolled therapist providing oversight of the physical therapy assistant, occupational therapy assistant, or speech-language assistant.N.H. Admin. Code § He-W 568.10
(See Revision Note at chapter heading He-W 500); ss by #4995, eff 11-30-90, EXPIRED: 11-30-96
New. #7909, eff 6-24-03; ss by #9929, INTERIM, eff 6-19-11, EXPIRES: 12-16-11; ss by #10042, eff 12-16-11
Amended by Volume XLII Number 14, Filed April 7, 2022, Proposed by #13355, Effective 3/19/2022, Expires 3/19/2032