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Montgomery County Benefit Plan

FY17 Sliding Fee Scale

Please note the change in date from July 1, 2017 to July 1, 2017 in several places in the FY17 Sliding Fee document.  Transitions will start on July 1, 2017 as outlined in the attachment.

Effective July 1, 2017, the Montgomery Co. ADAMHS will begin transition to a new sliding fee scale.  The ’s sliding fee scale for Medicaid billable services will begin at 139% of the Federal Poverty Level. 

In order to create a smooth transition to the sliding fee scale, agencies will be expected to transition individuals based on the following guidelines:

  • New Individuals/Clients:  Will immediately be placed on the new sliding fee scale beginning July 1, 2017.
  • Active/Open Individuals:  Beginning, July 1, 2017 and each month thereafter through December 31, 2017, the “active” clients will transition to the new sliding fee scale at the time their 6 month financial review is completed. 

On January 1, 2017, all individuals will be transitioned completely to the FY17 sliding fee scale.  The FY16 sliding fee rider codes will become “inactive” for any claims dated after January 1, 2017. 

There are two ways for agencies to ensure they receive payment for Medicaid services for people who are Medicaid eligible after July 1, 2017:

  • Retro-Active Medicaid:  Provide assistance to complete a Medicaid application and ensure the individual marks “YES” to the question “Do you want help paying for medical bills from the last three months?” (Question 12)
  • Presumptive Eligibility Medicaid:  Become an agency certified as a “presumptive eligibility” Medicaid site and assist individuals in turning in an application via the presumptive eligibility process.  This process will enable the agency to obtain a temporary Medicaid number for individuals until their Medicaid application is processed. It is important for agencies to move forward immediately with the presumptive eligibility Medicaid designation to ensure payment for services provided to new clients who meet Medicaid eligibility guidelines.


FY17 Sliding Fee Schedule can be accessed here...


FY16 Sliding Fee Schedule can be accessed here...


FY15 Sliding Fee Schedule can be accessed here...


Subsidy Worksheet Examples of Mental Health and Alcohol and Drug Services also available (not a complete listing.)



 
 
Pharmacological Management   Community Psychiatric Supportive Treatment (Individual)
Mental Health Assessment (non-physician)   Community Psychiatric Supportive Treatment (Group)
Psychiatric Diagnostic Interview (Physician)   Alcohol and Other Drug Assessment
BH Counseling and Therapy (Individual)   Alcohol and Other Drug Case Management
BH Counseling and Therapy (Group)   Crisis Intervention
Crisis Intervention MH Services   Alcohol and Other Drug Family Counseling
Foster Care   Alcohol and Other Drug Group Counseling
Residential Care   Alcohol and Other Drug Individual Counseling
30 Days of Temporary Housing   Alcohol and Other Drug Laboratory Urinalysis
Partial Hospitalization (Less than 24 hrs.)   Alcohol and Other Drug Methadone Administration
 
     
 
Mental Health Services

Between July 1, 2014 and June 30, 2015, if it is in your Individual Service Plan, you are eligible for:

104 hours of Community Psychiatric Support
24 hours of Pharmacological Management
52 hours of Counseling
2 hours of Assessment by Physician
4 hours of Assessment (Non-Physician)
90 days of Residential Treatment
30 days of Temporary Housing
 
     
 
Alcohol & Other Drug Services Beginning

July 1, 2014 through June 30, 2015, if you are over 21 and it is in your Individual Service Plan, you are eligible for 90 days of a combination Room and and/or Residential Treatment in a treatment facility.