Remittance Advice Alerts/PROMISe Banner Pages
Subject: Community Support Service Providers - Federal Financial Participation Rate Change and Continued Billing Requirements
Banner Date: 9/15/2017
Cycles: 12,13,14,15
Provider Types/Specialties: 11/115; 21/221 and 21/222
 
Subject: Community Support Service Providers - Federal Financial Participation Rate Change and Continued Billing Requirements

The Centers for Medicare and Medicaid Services (CMS), requires the Commonwealth of Pennsylvania, Department of Human Services, Office of Mental Health and Substance Abuse Services (OMHSAS) to assure all providers affirm payment of state funds prior to submitting invoices to PROMISe™ for federal reimbursement for recipients served in the fee-for-service program. Documentation should be maintained in the patient’s record at the provider entity and the County entity remains responsible for maintaining records of all state monies distributed.
 
With the start of the new federal fiscal year 2017/2018, which begins on October 1, 2017, the Federal Financial Participation (FFP) rate of reimbursement will change to 51.82 percent; the state portion will be 48.18 percent.
 
The Department-established fees for these services along with federal and state splits for dates of service on or after October 1, 2017 are:
 
SpecialtyServiceFeeFederalState
115Family Based Mental Health Services$26.93$13.96$12.97
221Resource Coordination – Mental Health$12.24$ 6.34$ 5.90
222Intensive Case Management – Mental Health$12.45$ 6.45$ 6.00
222Blended Case Management – Mental Health$12.45$ 6.45$ 6.00
 
Individual provider letters will not be generated for the services listed in this RA Alert.
 
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