10:76-2.4 PACT beneficiaries receiving other mental health services
(a) A PACT provider shall not request reimbursement for PACT services delivered during the same month the beneficiary is also receiving mental health personal care assistance (PCA) services.
(b) Partial care/partial hospitalization (PC/PH) services shall not be available, except if clinically indicated and recommended by the PACT team, for up to the last 30 days before a beneficiary terminates from PACT services. The PACT agency shall obtain prior authorization for services before enrolling a beneficiary in a PC/PH program. See N.J.A.C.10:76-2.5.
(c) A PACT provider shall not request reimbursement for PACT services delivered during the same month the beneficiary is also receiving integrated case management services (ICMS).
(d) A PACT provider shall not request reimbursement for PACT services when the beneficiary is also receiving mental health rehabilitation services provided in/by community residence programs during the same month of service.
R.2003 d.89, effective March 3, 2003. See: 34 N.J.R. 1593(a), 35 N.J.R. 1281(a). Amended by R.2004 d.8, effective January 5, 2004. See: 35 N.J.R. 2620(a), 35 N.J.R. 4204(a), 36 N.J.R. 189(a). Added (d).