The rates established to reimburse or calculate earnings represent what DHS/DASA has determined it will pay for each service. However, the applicable rate may not always cover the actual cost of the service. When this occurs, it is expected that providers can demonstrate how the remainder of the cost will be collected to ensure fiscal solvency. Additionally, providers who serve patients who are not contract eligible, cannot charge such patients LESS than the DHS/DASA uniform or negotiated rate for that service.

Reimbursement rates for FY 2012 are as follows:

Service Minimum Unit of Service Code Rate
Admission and Discharge Assessment Quarter Hour AAS $63.36 - per hour $15.84 - per quarter hour
Level I (Individual) Quarter Hour OP $60.32 - per hour $15.08 - per quarter hour
Level I (Group) Quarter Hour OP $22.80 - per hour $5.70 - per quarter hour
Level II (Individual) Quarter Hour OR $60.32 - per hour $15.08 - per quarter hour
Level II (Group) Quarter Hour OR $22.80 - per hour $5.70 - per quarter hour
Level III.1 Daily HH $64.86
Level III (Detoxification) Daily DX Provider Specific
Level III.5 Daily RR Provider Specific
Recovery Home - Adult Daily RH $46.65
Recovery Home - Adolescent Daily RH $118.45
Case Management Quarter Hour CM $46.68 - per hour $11.67 - per quarter hour
Psychiatric/Diagnostic Per Encounter/Per Day   - $78.94
Opioid Maintenance Therapy (less than 105 patients) Weekly OP $85.35
Opioid Maintenance Therapy (more than 104 patients) Weekly OP $68.28
Early Intervention (Individual) Quarter Hour EI $60.32 - per hour $15.08 - per quarter hour
Early Intervention (Group) Quarter Hour EI $22.80 - per hour $5.70 - per quarter hour
Community Intervention Quarter Hour CIH $45.56 - per staff hour $11.39 - per staff hour
Child Domiciliary Support Daily CRD $48.71
Toxicology Per Test TOX As specified in exhibit
HIV Counseling and Testing Quarter Hour HIV $56.24 - per hour $14.06 - per quarter hour