Current through November 28, 2024
(a) If an
individual requests treatment, or is referred by a court or other agency, as an
individual who is suspected of having a behavioral health disorder that could
require behavioral health services, the department will pay
(1) a community behavioral health services
provider for the following services:
(A) one
of the following behavioral health intake assessments:
(i) a mental health intake assessment under
(b) of this section;
(ii) a
substance use intake assessment under (c) of this section;
(iii) an integrated mental health and
substance use intake assessment under (d) of this section;
(B) a psychiatric assessment under (e) of
this section;
(C) psychological
testing and evaluation under (g) of this section;
(2) a mental health physician clinic for
(A) a mental health intake assessment under
(b) of this section;
(B) a
psychiatric assessment under (e) or (f) of this section;
(C) psychological testing and evaluation
under (g) of this section.
(D) an
integrated mental health and substance use intake assessment under (d) of this
section.
(b)
To qualify for payment, a mental health intake assessment must be
(1) documented in the recipient's clinical
record in accordance with
7
AAC 105.230 and
7
AAC 135.130;
(2) conducted in accordance with
(A) the requirements of
7
AAC 135.010(b)(1), if the provider is
a community behavioral health services provider;
(B) the requirements of
7
AAC 135.030(d), if the provider is a
mental health physician clinic;
(3) conducted upon admission to services and
during the course of active treatment as necessary, for the purpose of
determining and documenting
(A) the
recipient's mental status and social and medical history;
(B) the nature and severity of any identified
mental health disorder;
(C) a
diagnosis consistent with the
(i)
Diagnostic and Statistical Manual of Mental Disorders, adopted
by reference in
7
AAC 160.900;
(ii)
International Classification of
Diseases, adopted by reference in
7
AAC 160.900; or
(iii)
Diagnostic Classification of
Mental Health and Developmental Disorders of Infancy and Early Childhood:
Revised Edition (DC:0-3R), adopted by reference in
7
AAC 160.900;
(D) treatment recommendations that form the
basis of a subsequent behavioral health treatment plan; and
(E) functional impairment; and
(4) updated as new information
becomes available.
(c)
To qualify for payment, a substance use intake assessment must be
(1) documented in the recipient's clinical
record in accordance with
7
AAC 105.230 and
7
AAC 135.130;
(2) conducted at a minimum by a substance use
disorder counselor, behavioral health clinical associate, or other qualified
program staff member performing duties regularly within the scope of the
individual's training, experience, and education; however, if the substance use
intake assessment is conducted as part of withdrawal management services
subject to 7 AAC 70.110 and
7
AAC 135.190, the assessment must be conducted by an
individual identified in
7
AAC 70.110 for the type of withdrawal management
service provided;
(3) conducted
upon admission to services and during the course of active treatment as
necessary, for the purpose of determining and documenting
(A) if the recipient has a substance use
disorder;
(B) the nature and
severity of any identified substance use disorder;
(C) the correct diagnosis;
(D) treatment recommendations that form the
basis of a subsequent behavioral health treatment plan; and
(E) functional impairment; and
(4) updated as new information
becomes available.
(d)
To qualify for payment, an integrated mental health and substance use intake
assessment must
(1) be documented in the
recipient's clinical record in accordance with
7
AAC 105.230 and
7
AAC 135.130;
(2) be conducted in accordance with
(A) the requirements of
7
AAC 135.010(b)(1), if the provider is
a community behavioral health services provider;
(B) the requirements of
7
AAC 135.030(d), if the provider is a
mental health physician clinic;
(3) meet the requirements of (b)(3) and
(c)(3) of this section; and
(4) be
updated as new information becomes available.
(e) The department will pay a community
behavioral health services provider or mental health physician clinic for a
psychiatric assessment interview, that is to serve as the professional
behavioral health assessment under this section, if the recipient's condition
indicates the need for a more intensive assessment, including an assessment to
evaluate the need for medication. A psychiatric assessment interview must
(1) be conducted by a professional described
in 7 AAC 135.010(b)
(2);
(2) include a review of any general medical
and psychiatric history or problem the recipient is presenting;
(3) include a relevant recipient
history;
(4) include a mental
status examination;
(5) result in a
diagnosis consistent with the
(A)
Diagnostic and Statistical Manual of Mental Disorders, adopted
by reference in
7
AAC 160.900;
(B)
International Classification of
Diseases, adopted by reference in
7
AAC 160.900; or
(C)
Diagnostic Classification of
Mental Health and Developmental Disorders of Infancy and Early Childhood:
Revised Edition (DC:0-3R), adopted by reference in
7
AAC 160.900;
(6) include a listing of any identified
psychiatric problems, including functional impairments, with treatment
recommendations.
(g) The
department will pay a community behavioral health services provider, mental
health physician clinic, or psychologist for psychological testing and
evaluation to assist in the diagnosis and treatment of mental and emotional
disorders. Psychological testing and evaluation includes the assessment of
functional capabilities, the administration of standardized psychological
tests, and the interpretation of findings, and must be conducted in accordance
with
(1) the requirements of
7
AAC 135.010(b) (1), if the provider
is a community behavioral health services provider;
(2) the requirements of
7
AAC 135.030(d) and (e), if the
provider is a mental health physician clinic;
(3) the requirements of
7
AAC 135.030(a), if the provider is a
psychologist.
Authority:AS
47.05.010
AS
47.07.030
