Sec. 10.21.25.06. Fee Schedule — Additional Treatment Services

A. Psychological Testing. The Department shall reimburse a psychologist for conducting psychological testing, up to a maximum of 8 hours per year per individual as follows:

(1) OMHC psychologist ... $99.02 per hour;

(2) Other psychologist ... $99.02 per hour;

(3) OMHC psychologist associate ... $27.55 per hour;

(4) Other psychologist associate ... $27.55 per hour.

B. Occupational Therapy. The Department shall reimburse an occupational therapist for providing services, as follows:

(1) To an individual, payable in 15-minute increments, for face-to-face:

(a) Therapeutic activities ... $11.83 per 15 minutes;

(b) Self-care, home management training ... $11.83 per 15 minutes;

(c) Community and work reintegration ... $11.83 per 15 minutes;

(d) Development of cognitive skills ... $11.83 per 15 minutes;

(e) Occupational therapy evaluation and re-evaluation ... $15.07 per 15 minutes;

(2) For each individual, up to a maximum of 10, in a group therapy session of a minimum of 60 minutes ... $18.30.

C. Physician Services. The Department shall reimburse for services rendered to a child, adolescent, or adult, by an appropriately privileged physician or certified registered nurse practitioner - psychiatric only, as follows:

(1) The patient's primary care physician in an inpatient or partial hospital setting:

(a) Initial care:

(i) For a minimum of 30 minutes ... $108.43;

(ii) For a minimum of 50 minutes ... $147.19;

(iii) For a minimum of 70 minutes ... $216.47;

(b) Subsequent care:

(i) For a minimum of 15 minutes ... $41.71;

(ii) For a minimum of 25 minutes ... $76.73;

(iii) For a minimum of 35 minutes ... $110.63;

(c) Discharge day management:

(i) For 30 minutes or less ... $77.68;

(ii) For more than 30 minutes ... $114.63;

(d) For discharge data submission ... $21.53;

(e) For individual therapy, in an inpatient setting:

(i) For 30 minutes ... $43.78;

(ii) For 45 minutes ... $82.30;

(2) The patient's primary certified registered nurse practitioner - psychiatric, in an inpatient or partial hospital setting:

(a) Initial care:

(i) For a minimum of 30 minutes ... $108.43;

(ii) For a minimum of 50 minutes ... $147.19;

(iii) For a minimum of 70 minutes ... $216.47;

(b) Subsequent care:

(i) For a minimum of 15 minutes ... $41.71;

(ii) For a minimum of 25 minutes ... $76.73;

(iii) For a minimum of 35 minutes ... $110.63;

(c) Discharge day management:

(i) For 30 minutes or less ... $77.68;

(ii) For more than 30 minutes ... $114.63;

(d) For individual therapy, in an inpatient setting:

(i) For 30 minutes ... $30.65;

(ii) For 45 minutes ... $57.61;

(3) For electroconvulsive therapy, in an inpatient setting:

(a) Including monitoring ... $98.39;

(b) Anesthesia ... $98.27;

(4) A consultant physician, or a consultant certified registered nurse practitioner - psychiatric, in an inpatient or partial hospital setting, initial consult, for a minimum of:

(a) 20 minutes ... $51.66;

(b) 40 minutes ... $79.60;

(c) 55 minutes ... $121.30;

(d) 80 minutes ... $174.86;

(e) 110 minutes ... $217.80;

(5) A consultant physician or a consultant certified registered nurse practitioner - psychiatric, in an outpatient setting:

(a) For a minimum of 15 minutes ... $51.49;

(b) For a minimum of 30 minutes ... $96.74;

(c) For a minimum of 40 minutes ... $131.91;

(d) For a minimum of 60 minutes ... $194.98;

(e) For a minimum of 80 minutes ... $237.73;