§ 3614-D — Universal standards for coding of payment for medical assistance claims for long term care

§ 3614-d. Universal standards for coding of payment for medical\nassistance claims for long term care. Claims for payment submitted under\ncontracts or agreements with insurers under the medical assistance\nprogram for home and community-based long-term care services provided\nunder this article, by fiscal intermediaries operating pursuant to\nsection three hundred sixty-five-f of the social services law, and by\nresidential health care facilities operating pursuant to article\ntwenty-eight of this chapter shall have standard billing codes. Such\ninsurers shall include but not be limited to Medicaid managed care plans\nand managed long term care plans. Such payments shall be based on\nuniversal billing codes approved by the department or a nationally\naccredited organization as approved by the department; provided,\nhowever, such coding shall be consistent with any codes developed as\npart of the uniform assessment system for long term care established by\nthe department and shall include, for any entity operating pursuant to\nsection three hundred sixty-five-f of the social services law a code\nthat is specific to the hourly cost of services at an overtime rate;\nprovided, however, that this section shall not be construed to require\nthe department to develop an overtime rate.\n