PUBLIC NOTICE
Department of Health Services
Behavioral Treatment Group Treatment
The State of Wisconsin reimburses providers for services provided to Medical Assistance recipients under the authority of Title XIX of the Social Security Act and ss. 49.43 to 49.47, Wisconsin Statutes. This program, administered by the State's Department of Health Services (the Department), is called Medical Assistance (MA) or Medicaid. In addition, Wisconsin has expanded this program to create the BadgerCare Plus programs under the authority of Title XIX and Title XXI of the Social Security Act and s. 49.471 of the Wisconsin Statutes. Federal statutes and regulations require that a state plan be developed that provides the methods and standards for reimbursement of covered services. A plan that describes the reimbursement system for the services (methods and standards for reimbursement) is in effect. Change in Covered Services and Payment Methods
The Department is expanding coverage for the Behavioral Treatment benefit, to include group adaptive behavior treatment and group adaptive behavior treatment with protocol modification. Group behavioral treatment is defined as a single provider servicing multiple members during a single session.
The rates for this new service are as follows:
HCPCS | Description | Reimbursement Rate |
The change will be effective December 1, 2022. The change to Medicaid, BadgerCare, and BadgerCare Plus is projected to result in increased annual expenditures of $22,002.82 all funds (AF), composed of $13,905.79 federal match (FED) and $8,097.03 state funds/general purpose revenue (GPR).
Copies of Changes
Copies of the Medicaid state plan amendment may be obtained free of charge by calling or writing:
Mail:
Bailey Dvorak
Bureau of Benefits Policy Division of Medicaid Services
P.O. Box 309
Madison, WI 53701-0309
Phone: (608) 267-5210
Fax:
(608) 266-1096
Attention: Bailey Dvorak
Copies of the state plan change will be made available for review at the main office of any county department of social services or human services.
Written Comments
Written comments are welcome. Written comments on the proposed changes may be sent by FAX, e- mail, or regular mail to the Division of Medicaid Services as described above. All written comments will be reviewed and considered.
Because the State Office Building at 1 West Wilson Street, Madison, Wisconsin is currently closed to the public, written comments will not be available for in person public review. Requests to review written comments received may be submitted to the Division of Medicaid Services as described above. Revisions may be made in the proposed change based on comments received.
