An assessment (see Chapter 10.1) and Individualized Program Plan (IPP) (see Chapter 10.2) must be completed to address participant’s deficits. The CRS counselor or CRS program staff member must receive an update or participate in a team meeting to discuss the participant’s status. The update should include the individual’s condition, course of treatment, progress, or lack of progress made toward reaching the treatment goals, with supporting data. The CRS counselor may request additional supporting documentation as needed. This must be reviewed to preauthorize additional services based on the following schedule:
- if the participant is receiving 2-4 hours of service per week, the provider must submit an update every 60 days;
- if the participant is receiving 5 or more hours of service per week, the provider must submit an update monthly.
*Note: outpatient services differ from post-acute rehabilitation services (PARS) non-residential which requires a full interdisciplinary team meeting. Outpatient therapy should be reserved for individualized services with a lower level of care while PARS non-residential require more intensive level of care for services.