361 CMYK Red If you need to connect with resources in your community, but don't know where to look, PA 211 is a great place to start. 0.000000 Additionally, a conditional plan for fire safety inspection and fire drills must be reviewed and approved by OMHSAS. PROCESS CMYK 0000002864 00000 n If you would like to comment on the current content, please use the 'Content Feedback' button below for instructions on contacting the issuing agency. 2010-12-29T10:45:02-05:00 You may be trying to access this site from a secured browser on the server. Level 2 programs provide essential addiction education and treatment components and have two gradations of intensity. You are using an unsupported browser. No changes found for this content after 1/03/2017. 70.000000 See key details from the, You are on primary menu. Group 1 Paragraph. 5 0 obj 30.000002 0.000000 <<690F30FA3816B046A3F2C5243FD12EBB>]/Prev 57889>> Laboratory (when related to a behavioral health diagnosis and prescribed by a behavioral health practitioner under the practitioner's scope of practice) Medically Managed Intensive Inpatient - Drug and Alcohol. 4462 % |g ,EQEQEQE%}l~u3NEQEQEQs_Init,AYc%EQEQEQE)In^^[i7^s(Tk6?r?T.I)PN 0.000000 100.000000 100.000000 Carelon manages behavioral health services for Medical Assistance (MA) recipients in 11 Western Pennsylvania counties: Armstrong, Beaver, Butler, Crawford, Fayette, Indiana, Lawrence, Mercer, Venango, Washington, and Westmoreland. 100.000000 1:10 . C=5 M=0 Y=90 K=0 <>>> 0.000000 Microsoft Edge, Google Chrome, Mozilla Firefox, or Safari. C=0 M=95 Y=20 K=0 0000000998 00000 n 100.000000 <>stream 60.000004 DHS has suspended the requirement that a Mental Health Professional sign each individual residential service plan and service plan review. assignment. 95.000000 PROCESS endstream endobj 800 0 obj <. Part B may cover partial hospitalization in some cases, if you meet certain requirements and if your doctor certifies that you would otherwise need inpatient treatment. CMYK 19.999998 will also bring you to search results. The programs are an alternative for youth at risk of inpatient psychiatric hospitalization as a result of difficulty functioning in school, at home and in the community. C=40 M=70 Y=100 K=50 CMYK (7) Have the cognitive and emotional ability to participate in the active treatment process and can tolerate the intensity of the partial hospitalization program. 1/1.1 80.000000 PROCESS partial hospitalization program (PHP) services that are in accordance with regulations at 424.24(e). C=80 M=10 Y=45 K=0 White C=0 M=90 Y=85 K=0 Additionally, a conditional plan for fire safety inspection and fire drills must be reviewed and approved by OMHSAS. 817 0 obj <>stream Chap. Navigate by entering citations or phrases 0.000000 gcPrJR^66f4Wl\F 3&YT.'3}-}^P Z,W2hyBpp2]z3^Pp@i+RSz^.um;_l2YrH0%)o6]_%barQQ 59.999104 partial hospitalization programs may treat adolescents 14 years of age and older when . 209/Tuesday, October 29, 2013/Rules and Regulations DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Part 485 [CMS-3202-F] RIN 0938-AP51 . 151 -Fire, Safety and Disaster ServicesChap. 100.000000 PROCESS (ii) Occupational therapy requiring the skills of a qualified occupational therapist, provided by an occupational therapist, or under appropriate supervision of a qualified occupational therapist by an occupational therapy assistant as specified in part 484 of this chapter. CMYK Mountville, PA 17554 P: 877.907.7970 P: 717.285.7121 F: 717.285.2658 False 139 -Neonatal ServicesChap. CMYK PROCESS 0.000000 0.000000 It is outside of the scope of this Billing and Coding: Partial Hospitalization Programs A56685 article to list all circumstances where the services represented by CPT code 96116 may be appropriately performed outside of the context of the . 65.000000 Partial hospitalization is also used . Home. 50.000000 Payment for peer support services is subject to the provisions of these requirements, 55 Pa. Code Chapter 1101 (relating to general provisions) and the limitations established in 55 Pa. Code Chapter 1150 (relating to the MA program payment policies) and the MA program fee schedule. Water Gap Wellness Center, located in East Stroudsburg, offers a complete offers a complete spectrum of treatment options to address every stage in the recovery or mental health journey. View the most recent official publication: These links go to the official, published CFR, which is updated annually. hbbd```b``+@$8dL U~"ol/I &Fu`q ` vn Regulation Y PROCESS HS has suspended the requirement related to the frequency of the fire safety inspection; however, LTSRs must take due diligence to try to obtain fire safety inspection within the required time frame. PROCESS 100.000000 Adobe Illustrator CS5 OMHSAS-Temporary Suspension of Specified Regulatory Requirements, 55 Pa. Code Chapters 1151, 1153, 1155, 1223, 5100, 5200, 5210, 5221, 5230, 5310, 5320, 5240, sychiatric Outpatient Clinics licensed under 55 Pa. Code Chapter 5200 will have 90 additional days, after the currently required 180 days, to update treatment plans that are created after the Disaster Proclamation was issued on March 6, 2020. (iii) Services of social workers, trained psychiatric nurses, and other staff trained to work with psychiatric patients. 2010-12-29T10:57:37-05:00 Our Locations. These requests should be submitted to the respective OMHSAS Regional Office. 0.000000 Timeframes for the completion of training and certification requirements for staff that provide certain services. 115 -Medical Record ServicesChap. 146 -Infection ControlChap. MA Program payment requirements in 55 Pa. Code 1153.52, regarding minimum number of hours of treatment in a Partial Hospitalization program day, have also been suspended. You may be trying to access this site from a secured browser on the server. <> 0.003099 0.000000 <> (3) Nurse practitioner and clinical nurse specialist services, as defined in section 1861(s)(2)(K)(ii) of the Act. 133 -Special Care UnitsChap. 0.000000 65.000000 (c) Partial hospitalization programs are intended for patients who. 50.000000 Since 1999, Carelon has managed behavioral health services as part of the HealthChoices program. For Intensive Case Management licensed under 55 Pa. Code Chapter 5221, DHS suspended the requirements for caseload size, supervisor-to-staff ratio, and supervisory contact. 0.000000 OMHSAS does not require a letter of support from the county for those individual waiver requests. 0000001128 00000 n C=0 M=0 Y=0 K=100 14.999998 100.000000 0.000000 . CMYK Blue C=50 M=100 Y=0 K=0 CMYK The CPT /HCPCS codes listed in Group 1: Codes describe covered services when performed in the context of partial hospitalization. Partial Hospitalization Programs (PHP) were treatment programs originally developed to help people struggling with mental illness. 0.000000 The Regional Field Offices and the counties they cover are listed . Generally, you'll work with a team of health professionals including psychiatrists, therapists, and nurses. %PDF-1.6 % PA 19047. <>stream PROCESS 0.000000 PROCESS result, it may not include the most recent changes applied to the CFR. 0.000000 Requirements regarding the minimum hours of operation. Chap. 2010-12-29T10:57:37-05:00 This contact form is only for website help or website suggestions. 0.000000 Philadelphia, PA. DHS has also suspended the MA program requirement in 55 Pa. Code 1153.52 that a psychiatrist shall be present in the psychiatric outpatient clinic outpatient facility to perform or supervise the performance of all covered services provided to MA beneficiaries. Call us. Also, although the requirement to conduct fire drills is suspended, the LTSR should make due diligence to conduct the fire drills within the required timeframe. Providers may utilize telehealth to develop the initial service plan and for the subsequent reviews of the plan. The Office of Mental Health and Substance Abuse Services (OMHSAS) is responsible for the licensure of a variety of services ranging from outpatient to inpatient mental health providers. 5.000001 Additionally, the service plans need to be updated at least once annually, instead of every six months. 45.000000 75.000000 79.998795 100.000000 Guidance for the Application of ASAM WM in PA SUD Tx System. Chap. Skip to article content, Intensive Behavioral Health Services (IBHS), Recovery, Resilience, Wellness & Peer Support, Ambulatory Withdrawal Management (WM) (Detox) Drug and Alcohol, Case Management Services (Includes Intensive Case Management, Resource Coordination, Blended Case Management, and Recovery Coaching), Clinically Managed Residential WM (Detox) Drug and Alcohol, Clinically Managed High Intensity Residential Drug and Alcohol, Clinically Managed Low Intensity Residential Drug and Alcohol, Clozapine (Clozaril) Monitoring and Support, Community Residential Rehabilitative (CRR) Host Home, Family Based Mental Health Services for Child/Adolescent, Intensive Behavioral Health Services (IBHS) Child/Adolescent, Intensive Outpatient Program (IOP) Services Drug and Alcohol, Laboratory (when related to a behavioral health diagnosis and prescribed by a behavioral health practitioner under the practitioners scope of practice), Medically Managed Intensive Inpatient Drug and Alcohol, Medically Managed Residential WM (Detox) Drug and Alcohol, Medically Monitored Inpatient WM (Detox) Drug and Alcohol, Medically Monitored Intensive Inpatient Drug and Alcohol, Mental Health Crisis Intervention Services, Outpatient Services Mental Health, Substance Use or Co-Occurring Services, Partial Hospital Programs for Substance Use Disorder, Partial Hospital Services for Mental Health, Substance Use or Co-Occurring Services, Psychiatric Rehabilitation Services (PRS), Residential Treatment Facilities (Child/ Adolescent), Early and Periodic Screening, Diagnostic and Treatment (EPSDT)*, Extended Acute Care (EAC) Hospital Based*, Extended Acute Care (EAC) Non-Hospital Based*, Mental Health Intensive Outpatient Services*, Residential Treatment Facilities (Adult)*. 80.000000 Chap. This content is from the eCFR and may include recent changes applied to the CFR. C=55 M=60 Y=65 K=40 90.000000 10.000002 0.000000 The provider must however facilitate other means of visitation using audio-video technology. November 7, 2019 Updated Policy for Provider Rate Request. C=0 M=0 Y=0 K=10 90.000000 C=35 M=60 Y=80 K=25 X0 % 8(x Pennsylvania's Medical Assistance Program as a BCM provider. formatting. Choosing an item from image/epsf C=90 M=30 Y=95 K=30 DHS has suspended the room size requirements in the event that a client must be moved or isolated or self-quarantined while participating in the program due to the programs adherence to guidelines issued by the CDC and the Pennsylvania Department of Health (DOH) for persons with COVID-19-related symptoms. For MA payment for Outpatient Drug and Alcohol services provided in accordance with 55 Pa. Code Chapter 1223, DHS will allow up to 60 days of intake to complete the Initial Treatment Plans instead of 15 days. 2&rf=,0J )F]GjRS-'u%)3X]f"/[>Ty h^KO0=Pd5-,Wg'pzAC the hierarchy of the document. Level 2.1 intensive outpatient programs provide 9-19 hours of weekly C=0 M=0 Y=0 K=80 Pressing enter in the search box 100.000000 C=75 M=100 Y=0 K=0 42 U.S.C. PROCESS 0.000000 0.000000 In addition, providers have seven days from the enrollment date to complete the residential service plan instead of completing it on the day of enrollment. PHPs provide structured, comprehensive care while allowing people to live outside . citations and headings Bulletin 15-03 Acute Partial Hospital Program Documentation Requirements. 100.000000 C=75 M=0 Y=100 K=0 These essential services are provided in a fashion that is reflective of the unique strengths and needs of each individual and is responsive to a dynamic and changing health care environment. 6C ak' 5 CLkhk$;&1` F$U)0G4.g0Z>UgnS{l~6N m5+.PrD}~^amE#uU6?(->p?$Uy$^jqG0E`r4&F",*CYLCYRu)({l;@r.r D* Ofy l%6jDW'DH{bVK trailer Adobe Photoshop CS3 Windows PROCESS C=0 M=35 Y=85 K=0 361.776367 C=100 M=95 Y=5 K=0 to meeting the staffing regulations of 28 PA Code Chapter 704 and provisions set forth by the DDAP Case Management and Clinical Services (CMCS) Manual, Single County . 0.000000 CMYK Medication-assisted treatment, if necessary. Click to skip to content, You are on secondary menu. 1 Winding Drive, Suite 106. CMYK The requirement that individual and group services be provided in the facility or in the community is also suspended; these can be provided via telehealth when appropriate. 100.000000 0.000000 They will be the lead clinician within the treatment environment and responsible for maintaining the integrity and efficiency of all aspects of the clinical treatment course of the therapeutic milieu. 147 -Environmental ServicesChap. 2010-12-29T10:57:37-05:00 Listed beloware the services provided by Magellans network of credentialed providers through your Pennsylvania HealthChoices plan. This service also helps individuals transition back into the community from a psychiatric hospital. DHS has suspended the maximum percentage limit on psychiatric time that can be provided via telehealth, allowing 100% of psychiatric services delivered via telehealth, if clinically appropriate to do so. 9000000/10000 100.000000 switch to drafting.ecfr.gov. The Program Director for our Partial Hospitalization programs will oversee sites in Williamsport and Danville. 143 -Podiatry UnitsChap. 256,257,258,259,262,274,277,284,530,531,282,283,296,301,318,319,529,532,306,270,271,272,305,315,33432;919A11CFA1D3A003A598C2212A8FBCD5 e requirements for annual and routine exams and medical and dental care for residents have also been suspended. 0000001745 00000 n PROCESS 0900 - Behavioral Health Treatment/Services. CMYK False 39.999996 \=AA47$l$I|[X-Z uO[Na*jGP=GrZ`9OD 55.000000 C=10 M=100 Y=50 K=0 PROCESS (00p7mma~l*PxRF About Us. dDt!( 19.999701 Similarly, payment will be made until January 17, 2021, to an agency that was approved to provide BHRS as of October 19, 2019, and otherwise complies with Chapters 1155 and 5240. CMYK While specific program variables may differ, all Partial Hospitalization Programs pursue the 0000000016 00000 n Training should focus on Centers for Disease Control and Prevention (CDC) recommendations and service provision, along with any new policies and procedures. proof:pdf 1 CFR 1.1 Initially called "day hospitals," these programs were designed in the 1960s to help those who needed an intensive level of psychiatric care but who would also benefit from living in the larger . These programs are available at an inpatient or residential treatment facility. 30.000002 startxref The requirement that intensive case management services be provided as needed in the place where the consumer resides or needs the service has also been suspended, thus allowing the use of telehealth to provide service as appropriate. Changes in Medicaid laws and the acceptance of addiction as a mental disorder allowed PHPs to also offer treatment to those with alcohol or substance use disorders (SUD). Signature requirements, including signatures for treatment plans and written consent, have been suspended. HRMs0+KBp;=ISNKG$C[lFhw}4(Q`rTl81J;C+v83DrUdQRskPB\ d >}FNRURLwH@>+8lH+nJ\FcNom}Io&cjIC,k,`Re\mh (i) Individual and group therapy with physicians or psychologists or other mental health professionals to the extent authorized under State law. 32.432129 Please call Member Services to determine if a service is available in your county. 75.000000 85.000000 6 0 obj 0.000000 Regulations, and Minimum Standards Authority: T.C.A. If you have comments or suggestions on how to improve the www.ecfr.gov website or have questions about using www.ecfr.gov, please choose the 'Website Feedback' button below. CBH may utilize more specific . 0000002452 00000 n These services may be provided via telehealth/telephone if clinically appropriate to do so. Signature requirements, including signatures for service plans and written consent, have also been suspended. 043x - Occupational Therapy. (eg: 0000001222 00000 n CMYK CMYK 0.000000 Verbal consent must be documented in the medical record at the time of service and providers are. 1 0 obj For Intensive Behavioral Health Services (IBHS) under 55 Pa. Code Chapter 1155, the Department of Human Services (DHS) has suspended the timelines until which MA payments will be made to an agency that is not licensed as an IBHS agency. 10/01/2021. 25.000000 %%EOF These services include therapeutic milieu; nursing . This document is available in the following developer friendly formats: Information and documentation can be found in our CMYK Verbal consent must be documented in the medical record at the time of service and providers are strongly encouraged to obtain signatures electronically when possible. 155 - Psychiatric Services. 9.999103 101 - General InformationChap. The psychiatrist may instead perform or supervise the services via telehealth if clinically appropriate to do so. C=0 M=0 Y=0 K=60 70.000000 PROCESS (5) Services furnished to SNF residents as defined in 411.15(p) of this chapter. Medicare only covers partial hospitalization if the doctor and the program accept. Requirements for obtaining verbal consent and documentation of the verbal consent remain and must be included in the medical record for every occurrence of a new and updated treatment plan. Partial hospitalization programs include a range of therapies and interventions. <>stream CMYK Client signature requirements, including those for residential plans, have been suspended. 0.000000 Individual patient training and education about your condition.
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