Irregular Payment Specific to Placement Setting 623-05-25-05

(Revised 10/1/2023 ML #3759)

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Irregular Payments Family Foster Care:

Children in foster care placed in a licensed or approved family foster home are eligible for irregular maintenance payments.

 

Irregular Payments for a Non-Foster Care Placement:

Children in foster care placed in a non-foster care setting with an unlicensed provider, at the hospital, or in relative/kinship care do not qualify for irregular maintenance payments.

 

Irregular Payments in Nexus-PATH Provider homes:

The irregular payment policy applies to children placed in Nexus-PATH provider homes. Children placed into Nexus-PATH meet eligibility for Enhanced Treatment Foster Care (ETFC), Treatment Foster Care (TFC) or Regular Foster Care (RFC). Children are eligible for:

  1. Category 10– codes 11, 12, 13, 14, 15, and 16

  2. Category 20– codes 21 and 22

  3. Category 40 – codes 41 and 43

  4. Category 50– codes 51 and 53

  5. Category 60 - codes 61, 62, 63 and 64 applies to Nexus-PATH Regular level of care only. The ND payment system does not allow for the entry of codes 61, 62, 63, or 64 as a separate irregular payment for Nexus-PATH providers. Therefore, when a code under category 60 is billed, the amount will be included/embedded in the standard maintenance payment amount when the monthly standard payment is authorized by FCSA Eligibility Unit.

  6. Category 70 – code 71, if the child in foster care has their own child in placement with them.

 

Irregular Payments in Qualified Residential Treatment Program (QRTP):


The irregular payment policy has very limited application to children in group and residential care. ND QRTP's have an established fee for service defined in N.D.A.C. 75-03-15.

Children placed in a QRTP are eligible for:

Irregular Payments in Psychiatric Residential Treatment Facility (PRTF's):

Foster care funds cannot be used to reimburse for any portion of a child's cost of care in a PRTF, including irregular payments. Irregular payments may be included in the PRTF’s direct rate based on historical costs as outlined in N.D.A.C 75-02-09-06 reimbursed by ND Medical Services.