Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 54 Pa.B. 488 (January 27, 2024).

55 Pa. Code § 1247.51. General payment policy.

PAYMENT FOR TARGETED CASE
MANAGEMENT SERVICES


§ 1247.51. General payment policy.

 (a)  The Department pays a predetermined fee for targeted case management services provided to eligible recipients by participating case managers subject to the conditions and limitations established in this chapter.

 (b)  Payment is made for targeted case management services provided in 15-minute units.

 (c)  The Department will determine the target groups eligible for targeted case management services.

 (d)  The Department will determine the geographic areas covered by targeted case management services.

 (e)  Targeted case management services are optional services available to eligible recipients.

 (f)  Recipient access to targeted case management services is as follows:

   (1)  Recipients may access targeted case management services through self-referral or referral by a physician, advocacy group, the local county assistance office or other person/agency acting on behalf of the recipient.

   (2)  Recipients may apply for a change in case managers by submitting a written request to the Department. Reassignment to another case manager takes effect 30 days from the date on which the request is received by the Department contingent upon the availability of an appropriate case manager.



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