Residential (RTC)
24-hour residential treatment. Per-diem billing where date-span integrity is critical and one gap between concurrent reviews can strand a stay.
- Revenue codes
- Typically 1001 / 1002 (per diem) — payer-specific
- Units
- Per diem; date-span integrity is critical
- Authorization
- Prior auth plus concurrent review at intervals
- Documentation
- Medical-necessity, level-of-care criteria
- Common denials
- Auth lapse between concurrent reviews, day-count mismatches, missing medical necessity
- Underpayment risk
- Per-diem paid below contracted rate