§ 1155.34. Payment conditions for group services.
(a) Payment will be made to a licensed IBHS agency for group services if the following conditions are met:
(1) There is a written order for group services that meets the requirements of § 1155.32(a)(1) (relating to payment conditions for individual services).
(2) A face-to-face assessment has been completed by a graduate-level professional within 15 days of the initiation of group services and prior to completing the ITP in accordance with § 5240.95 (relating to assessment) or a face-to-face assessment has been reviewed and updated within 12 months of the previous face-to-face assessment.
(3) The assessment and all updates have been signed by the staff person who completed the assessment.
(4) An ITP based upon the assessment and written order for group services has been completed within 30 days after the initiation of services in accordance with § 5240.96 (relating to individual treatment plan) or an ITP has been reviewed and updated within 6 months of the previous ITP.
(5) The ITP and all updates have been reviewed and signed by the youth, young adult, or parent or legal guardian of the child or youth, the staff person who completed the ITP and an individual who meets the qualifications of a clinical director in § 5240.12 (relating to staff qualifications).
(6) For continued group services, a child, youth or young adult shall have an order written within 12 months of the initiation of the continued services that complies with § 1155.32(a)(1)(ii)—(iv).
(b) Payment will be made to a licensed IBHS agency for individual interventions provided as part of group services when included in the child’s, youth’s or young adult’s ITP.
(c) Payment will be made to a licensed IBHS agency for group services for up to 45 days after initiation of services, if an ITP has not yet been completed but there is a written order for services that complies with subsection (a)(1) and there is a treatment plan for the group services provided.
Cross References This section cited in 55 Pa. Code § 1155.35 (relating to payment conditions for EBT delivered through individual services, ABA services or group services); 55 Pa. Code § 1155.37 (relating to limitations); 55 Pa. Code § 5240.41 (relating to individual records); 55 Pa. Code § 5240.94 (relating to group services initiation requirements); and 55 Pa. Code § 5240.96 (relating to individual treatment plan).
No part of the information on this site may be reproduced for profit or sold for profit.
This material has been drawn directly from the official Pennsylvania Code full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.
