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Psychiatric Residential Treatment Facilities (PRTF) Reserve Days

Date: 04/13/2017

Effective with dates of service on and after April 15, 2017, Psychiatric Residential Treatment Facilities (PRTF) shall use procedure code T2048 with modifier UC when billing reserve days.

All references to absentee or visitation days in the “PRTF Regulation, Service Standard, and Policy Manual” or other policies, procedures, or manuals are to be replaced with the terminology of “Reserve Days.”  Reserve days shall be defined when a resident is absent from a PRTF for more than 24 hours.  PRTFs will be reimbursed for reserve days at 100% of the facility specific per diem rate.  The resident’s  plan of care shall provide supporting documentation indicating frequency, duration and location of each reserve day along with specific documentation of PRTF administrative activities during the reserve day period.

Payment for reserve days shall be approved for days in which it is necessary to reserve a bed in a PRTF when the resident is absent for any of the following reasons:

  • Medical appointments
  • Hospital admission for a medical condition
  • Home visits
  • Court appointments
  • Supervised visitation
  • Other approved visitations indicated in the residents’ plan of care
  • Personal business (i.e. funeral, wedding, graduation, etc.)
  • Resident leaves the facility without permission (i.e. AWOL)

There is no limited to the number of reserve days the resident can have in a calendar year.

Questions please contact Customer Service 1-866-896-7293.