This section establishes reimbursement rates for services provided under Title 22-A DCMR Chapter 80, directing the Department of Behavioral Health to reimburse non-Medicaid providers at the same rates as the DC Medicaid fee schedule. It specifically sets the local-only rate for Psychiatric Crisis Stabilization Room and Board (service code S9485-U2), tying it to the Chapter 64 substance use residential room and board rate (H0043). Providers must follow the published DC Medicaid fee schedule for all other Chapter 80 services, and any future rate changes to the crisis stabilization room and board rate require a Public Notice in the D.C. Register with opportunity for comment.
View official source8101 REIMBURSEMENT RATE 8101.1 The Department of Health Care Finance has published rates for Medicaid-funded services under Title 22-A District of Columbia Municipal Regulations (DCMR), Chapter 80. Those rates are contained in the District of Columbia Medicaid fee schedule available online at www.dc-medicaid.com. The Department of Behavioral Health (“the Department”) shall reimburse providers for Chapter 80 services provided to non-Medicaid beneficiaries at the same rates as contained in the District of Columbia Medicaid fee schedule. 8101.2 Reimbursement for the local-only services provided under Title 22-A DCMR Chapter 80, which includes Psychiatric Crisis Stabilization Room and Board, are set forth in the table below. This rate is the same as the local-only substance use service rate provided under Title 22-A DCMR Chapter 64, Residential Room and Board, Code H0043. The Department shall update the Psychiatric Crisis Stabilization Room and Board rate to reflect any future changes to the Chapter 64 substance use service rate by publishing a Public Notice in the D.C. Register and providing an opportunity for meaningful comment before implementation. The Notice shall describe the type of change, the reason for the change, the effective date of the change, and the new local only reimbursement rate. SERVICE CODE RATE per UNIT ($) UNIT Psychiatric Crisis Stabilization Room and Board S9485- U2 See Title 22-A District of Columbia Municipal Regulations (DCMR), Chapter 64, Residential Treatment, Room & Board (H0043) Per diem 8101.3 All future updates to the service codes and rates will be included in the District of Columbia Medicaid fee schedule pursuant to the procedures established in Title 29 DCMR, Section 988, by providing notice and an opportunity for comment. SOURCE: Final Rulemaking published at 67 DCR 14199 (December 4, 2020). District of Columbia Municipal Regulations Mental Health 22-A DCMR § 8101