Frequently Asked Questions

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What are eligible settings for Children and Family Treatment and Support Services?

Children and Family Treatement and Support services can be provided in the community, and in Community Residences (OMH). Services can also be provided in any licensed foster care setting, including institutions (e.g. RTC). Services cannot be provided in any hospital, inpatient or Residential Treatment Facility level of care.

Source: CFTSS June 2018

What is included in offsite rate for CFTSS? Is it per site or per unit/per client?

The off-site rate supplements the base service rate to account for additional costs associated with off-site billing. The base service rate codes and the off-site rate codes that correspond should be billed for the number of units the service was provided. The rates are billed per client. These rate codes will be billed on separate claims. 

Source: July 2018 CFTSS Billing In-Person Training

What makes a CFTSS service offsite? Is anything beyond administrative site offsite?

Offsite services are intended to be provided in the child’s home or community. All locations, including satellites, are considered on-site.

Source: CFTSS: OLP, PSR, CPST Billing Update 11.6.18

For CFTS services provided to a group offsite, can you bill for offsite for each group member even though the group is obviously provided in one location?

Yes, once per client.

Source: CFTSS: OLP, PSR, CPST Billing Update 11.6.18

When a youth is hospitalized and an FPSS worker was at the home earlier the same day can Family Peer Support Services (FPSS) bill?

A FPSS provider cannot bill Medicaid for services while the child is in the hospital, as the hospital is already billing Medicaid for the child at that time.

However, if the service is provided before the child was admitted to the hospital, the service would be billable and not duplicative of another Medicaid service.  

As always, we encourage you to speak with your agency internal compliance officer and/or billing staff to delineate when a staff-person can serve the family.

Source: FPSS Preparing for MC Webinar May 2019

Can you provide a telehealth and in-person CORE Service for the same person on the same day and be able to bill for both services appropriately?

Yes, Providers serving an enrollee may submit one claim per day for each rate code/procedure code/modifier combination. In accordance with the CORE Services Operations Manual, and if clinically indicated, providers may submit claims for an in-person visit and telehealth visit for the same rate code in the same day.

Please see page 17 from CORE Benefit and Billing Guidance.

Source: OMH & OASAS CORE FAQ Dec 2021