IFPS and Medicaid

In some states, IFPS services are paid through Medicaid. Arizona is one of these states. Arizona has a Medicaid waiver that allows for a wide range of services delivered through our behavioral health system.

Medicaid reimburses the state for IFPS services on a shared cost basis with federal dollars covering most of the cost and the state the balance. Children in foster care automatically qualify for Medicaid. In-home services are covered by Medicaid if the family meets income eligibility requirements.

Medicaid will only pay for specific services so an IFPS intervention is broken down and coded into those services. Typically these services include:

  • Individual Therapy
  • Family Therapy—with or without child
  • Family Support
  • Respite
  • Case Management
  • Living Skills
  • Health Promotion

IFPS providers in Arizona are licensed through behavioral health services. The licensing standards are extensive and the list can be viewed here:
http://www.azdhs.gov/bhs/provider/provider_main.htm

You can see how Medicaid reimburses for IFPS in the following chart which lists the coding number, the description of services, unit of cost, and amount for typical IFPS services:

H2017 Psychosocial rehabilitation living skills training services, per 15 minutes

$23.30

H2025 Ongoing support to maintain employment, per 15 minutes

$9.13

H2027 Psychoeducational service (pre-job training and development), per 15 minutes

$13.08

S5110 Home care training, family (family support), per 15 minutes

$23.30

S5150 Unskilled respite care, not hospice, per 15 minutes

$7.49

S5151 Unskilled respite care, not hospice, per diem

$211.45

T1016 Office case management by behavioral health professional, each 15 minutes

$25.00

T1016 Out of office case management by behavioral health professional, each 15 minutes

$33.74

T1016 Office case management, by BHT, each 15 minutes

$17.50

T1016 Out of office case management, by BHT, each 15 minutes

$23.87

T1019 Personal care service, each 15 minutes

$5.80

H0004 Office, individual behavioral health counseling and therapy, per 15 minutes

$25.00

H0004 Home, individual behavioral health counseling and therapy, per 15 minutes

$33.74

H0004 Group behavioral health counseling and therapy, per 15 minutes

$7.58

H0004 Office, family behavioral health counseling and therapy with client present, per 15 minutes

$25.50

H0004 Out of office, family behavioral health counseling and therapy with client present

$36.85

H0004 Office, family behavioral health counseling and therapy without client present, per 15 minutes

$25.50

H0004 Out of office, family behavioral health counseling and therapy, without client present, per 15 minutes

$36.85

H0025 Behavioral health prevention/promotion education service

$14.00

H0031 Mental health assessment, by non-physician

$140.00

H2011 Crisis intervention service, per 15 minutes

$32.18

H2014 Skills training and development, per 15 minutes

$23.30

H2014 Group skills training and development, per 15 minutes per person

$11.60

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Posted by Anne Cornell, Clinical Consultant, Arizona.
If you have questions or need more information, please contact Anne at mustbinsun@aol.com.

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