Reimbursement for PASRR Level II Evaluations

Reimbursement for PASRR Level II Evaluations A. The Division of Medicaid reimburses the Pre-Admission Screening and Resident Review (PASRR) Level II Contractor for services rendered when the Contractor: 1. Completes and sends a PASRR Level II Billing Summary for MI monthly to the State PASRR Coordinator for review, and 2. Submits an invoice via Paymode to be electronically processed for reimbursement. B. The Division of Medicaid reimburses the Department of Mental Health (DMH) Regional Center Intellectual/Developmental Disability (IDD) Program when DMH: 1. Submits the PASRR Level II Roster for ID to the State PASRR Coordinator for review, and 2. Depending upon the person’s Medicaid eligibility status, reimbursement will be processed accordingly by the Division of Medicaid. C. The Division of Medicaid only reimburses for PASRR Level IIs which are: 1. Complete, and 2. Signed by the appropriate personnel who completed the assessments that are part of the PASRR Level II. D. The Division of Medicaid does not reimburse for: 1. Incomplete PASRR Level IIs, 2. Therapeutic services provided by community mental health centers (CMHCs) or private community health centers (PMHCs) in a nursing facility (NF) to persons who do not have an Appropriateness Review Committee (ARC) determination recommending the service, 3. PASRR Level II for persons who have a primary diagnosis of Alzheimer’s disease or other dementia which prevents them from benefitting from specialized services or those deemed to be in an advanced determination category, or 4. Multiple services provided for a person conducted and/or billed simultaneously.