17-1, Chapter 13.6.2, Billing Guidelines - Tiers

Revision 17-1; Effective Sept. 1, 2017

The following changes were made:

Chapter Title Change
13.6.2 Billing Guidelines - Tiers Adds based on the consumer’s need, which will be determined during the initial pre-admission assessment, the provider may request an admission tier of level 2 through level 8. This request is to be submitted in writing using Form 3149, Comprehensive Rehabilitation Services Request for Tier Change, or included in the pre-admission evaluation, which identifies services needed, frequency, duration and requested tier. Explains when submitting an invoice, Post-Acute Rehabilitation providers are required to submit a monthly summary that includes a descriptive breakdown of services provided; frequency, duration, progress, or lack of progress made towards the consumer's goals; actions to be taken; and preliminary discharge information. Providers are also required to upload service record details of daily services provided in the CRS Data Reporting System, per Chapter 13.2, Required Documentation. Providers will only be required to submit daily therapy documentation if a consumer's file is randomly selected for utilization review. The provider will receive a written request with a time frame outlining when documentation is to be returned to the CRS requestor.