10A NCAC 70O .0104. LIMITATIONS

(a)  A diagnosis is not acceptable unless the client is seen by the professional making the diagnosis and signing the documentation.

(b)  Drugs allowable do not include medication for conditions other than emotional disturbance.

(c)  Neither dentistry nor emergency medical treatment unrelated to emotional disturbance is reimbursable.

(d)  Follow‑up as a part of a discharge planning to benefit the client can be provided by the residential treatment staff if the client is discharged in the immediate or close‑by vicinity of the treatment facility; otherwise, other provisions for such services shall be secured.  Such activity as part of this service is not reimbursable after three months duration.

(e)  All treatment programs must be administered, directed, backed up, or supervised by appropriately qualified professionals.

(f)  Transportation can be included as a program cost only when it is necessary to provide services, i.e., make it possible for clients to participate in program related activities.

(g)  Costs for room and board cannot exceed 40 percent of the total amount for which reimbursement is made for providing residential treatment.

 

History Note:        Authority G.S. 143B‑153;

Eff. July 23, 1979;

Amended Eff. October 1, 1980;

Transferred from T10.43I .0605 Eff. July 1, 1983;

Amended Eff. June 1, 1990.