APA Bridge Payment - PRTF

This page is intended to be a resource for our provider network to find answers to critical questions during the COVID-19 crisis. As we receive more information, Community Care will be updating the site, so check back frequently for the most up-to-date information. As new questions are added, they will appear at the top of the list.

What is the purpose of the Psychiatric Residential Treatment Facility (PRTF) Alternative Payment Arrangement?

This APA is designed to offset some of the cost of mitigating the spread of COVID-19 and the daily increased operational costs for services associated with accepting new RTF admissions. It is not intended to cover the total COVID-19 related expenses for the provider’s entire program.

What is the PRTF APA payment to be used for?

Providers should use this APA to support paying and preserving provider staff and maintaining its ability to accept new members into the PRTF.

How are payments determined?

The APA will be in the form of a supplemental payment for each new PRTF admission beginning March 15, 2020 through June 30, 2020.

Do I have to provide any information to Community Care regarding this payment?

Providers should report the following: 1. Current PRTF total bed capacity tracking; and 2. Status of acceptance of new admissions. These should be sent on the form provided with your amendment to the following e-mail address: CCBHsigncontract@ccbh.com. Providers should also report premature PRTF discharges (all discharges with less than a 60- day length of stay) within two (2) days of discharge to your Community Care care manager, with the exception of established short-term PRTF programs.

Will I receive the PRTF APA payment electronically or by check?

Payments will be made in the manner in which providers receive reimbursement for claims.

What if I don’t want to participate in the PRTF APA payment initiative or if I have objections?

Providers may choose to ‘opt out’ of the PRTF APA. In addition, providers may object to language in the amendments. If so, providers should submit their objection or intent to opt-out by Friday, May 29, 2020 to the following e-mail address: ccbhsigncontract@ccbh.com

What should I do if I have questions related to the PRTF APA payment?

Please contact your Community Care Provider Relations Representative.

When will the PRTF APA payments be made?

Providers should expect to see payments the week of June 7, 2020.

Are providers expected to continue to bill for PRTF services?

Yes, providers should continue to submit claims and receive reimbursement for all services, including PRTF, delivered to HealthChoices eligible enrollees.

Is additional detail regarding provider-specific payments available?

Yes, the Community Care ePortal - Report Center will include provider-specific information. Below is a link to the user Guide for Report Center Downloads that can be used by Facility Administrators if they need help on how to grant permissions, as well as instructions on accessing the Downloads area and viewing files.

ePortal Report Center Downloads

In order to identify the files, the files will be named: COVID-19 RTF APA Bridge Payment