Remittance Advice Alerts/PROMISe Banner Pages
Subject: Community Support Service Providers - Federal Financial Participation Rate Change and Continued Billing Requirements
Banner Date: September 14, 2018 through October 16, 2018
Cycles: 12, 13, 14, 15 and 16
Provider Types/Specialty: 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 2018/2019, which begins on October 1, 2018 the Federal Financial Participation (FFP) rate of reimbursement will change to 52.25 percent; the state portion will be 47.75 percent.
 
The Department-established fees for these services along with federal and state splits for dates of service on or after October 1, 2018 are:
 
Specialty
Service
Fee
Federal
State
115
Family Based Mental Health Services
$26.93
$14.07
$12.86
221
Resource Coordination – Mental Health
$12.24
$6.40
$5.84
222
Intensive Case Management – Mental Health
$12.45
$6.51
$5.94
222
Blended Case Management – Mental Health
$12.45
$6.51
$5.94
Individual provider letters will not be generated for the services listed in this RA Alert.
 
Back to RA Banner List