{"id":38,"date":"2025-07-16T12:09:52","date_gmt":"2025-07-16T12:09:52","guid":{"rendered":"http:\/\/box5846.temp.domains\/~bluesid3\/?page_id=38"},"modified":"2025-07-16T18:38:26","modified_gmt":"2025-07-16T18:38:26","slug":"service-delivery","status":"publish","type":"page","link":"http:\/\/box5846.temp.domains\/~bluesid3\/service-delivery\/","title":{"rendered":"Service Determination Requests"},"content":{"rendered":"\n<p class=\"has-vivid-cyan-blue-color has-text-color has-link-color wp-elements-800e8898fe3fb9e52a063909e71b230d wp-block-paragraph\"><a href=\"https:\/\/www.ecfr.gov\/current\/title-42\/section-460.121\">42 CFR \u00a7 460.121<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A service determination request must be identified and processed when a request is made to initiate, modify, or continue a service, so long as the request is made after the initial plan of care is finalized. Service determination requests can be made orally or in writing, and can come from the participant, the participant&#8217;s representative, or a caregiver.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Unless it is considered an immediate approval, the PACE employee or contractor has 72 hours to present the request to the IDT. The IDT must provide an in person assessment and provide notification to the participant within 72 hours. An assessment is not required for an approval. The SDR is considered complete when notification is provided. <\/p>\n\n\n\n<p class=\"has-vivid-cyan-blue-color has-text-color has-link-color wp-elements-7d19e8b647f804e78a226cfcd0e4c533 wp-block-paragraph\"><a href=\"http:\/\/box5846.temp.domains\/~bluesid3\/?page_id=62\" data-type=\"page\" data-id=\"62\">Requests Made prior to Initial Plan of Care<\/a><\/p>\n\n\n\n<p class=\"has-vivid-cyan-blue-color has-text-color has-link-color wp-elements-86eccd5487f8c3a4f6e0755259d35de1 wp-block-paragraph\"><a href=\"http:\/\/box5846.temp.domains\/~bluesid3\/?page_id=45\" data-type=\"page\" data-id=\"45\">Immediate Approvals<\/a><\/p>\n\n\n\n<p class=\"has-vivid-cyan-blue-color has-text-color has-link-color wp-elements-4fa6ed483bb0a45b30e7bf416a9e6f55 wp-block-paragraph\"><a href=\"http:\/\/box5846.temp.domains\/~bluesid3\/?page_id=48\" data-type=\"page\" data-id=\"48\">Approvals<\/a><\/p>\n\n\n\n<p class=\"has-vivid-cyan-blue-color has-text-color has-link-color wp-elements-4e97595bffb66280fbf4997de1eec1b2 wp-block-paragraph\"><a href=\"http:\/\/box5846.temp.domains\/~bluesid3\/?page_id=46\" data-type=\"page\" data-id=\"46\">Denials<\/a><\/p>\n\n\n\n<p class=\"has-vivid-cyan-blue-color has-text-color has-link-color wp-elements-3277948fbdf52b2c267ebb2b69899a54 wp-block-paragraph\"><a href=\"http:\/\/box5846.temp.domains\/~bluesid3\/?page_id=81\" data-type=\"page\" data-id=\"81\">Partial Denials<\/a><\/p>\n\n\n\n<p class=\"has-vivid-cyan-blue-color has-text-color has-link-color wp-elements-9dae5bdd3b764941cf2198cadf20b24b wp-block-paragraph\"><a href=\"http:\/\/box5846.temp.domains\/~bluesid3\/?page_id=83\" data-type=\"page\" data-id=\"83\">Withdrawals<\/a><\/p>\n\n\n\n<p class=\"has-vivid-cyan-blue-color has-text-color has-link-color wp-elements-51ad2a2bb2ecce59b554ffafece11b21 wp-block-paragraph\"><a href=\"http:\/\/box5846.temp.domains\/~bluesid3\/?page_id=49\" data-type=\"page\" data-id=\"49\">Extensions<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>42 CFR \u00a7 460.121 A service determination request must be identified and processed when a request is made to initiate, modify, or continue a service, so long as the request is made after the initial plan of care is finalized. Service determination requests can be made orally or in writing, and can come from the [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-38","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"http:\/\/box5846.temp.domains\/~bluesid3\/wp-json\/wp\/v2\/pages\/38","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/box5846.temp.domains\/~bluesid3\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/box5846.temp.domains\/~bluesid3\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/box5846.temp.domains\/~bluesid3\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/box5846.temp.domains\/~bluesid3\/wp-json\/wp\/v2\/comments?post=38"}],"version-history":[{"count":8,"href":"http:\/\/box5846.temp.domains\/~bluesid3\/wp-json\/wp\/v2\/pages\/38\/revisions"}],"predecessor-version":[{"id":108,"href":"http:\/\/box5846.temp.domains\/~bluesid3\/wp-json\/wp\/v2\/pages\/38\/revisions\/108"}],"wp:attachment":[{"href":"http:\/\/box5846.temp.domains\/~bluesid3\/wp-json\/wp\/v2\/media?parent=38"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}