Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 425.000 - Psychiatric Inpatient Hospital Services
Section 425.417 - Conditions for Continuing Care
Universal Citation: 130 MA Code of Regs 130.425
Current through Register 1531, September 27, 2024
(A) To continue to qualify for psychiatric inpatient hospital services, members must continue to meet the admission criteria described in 130 CMR 425.406 or 425.407, whichever is applicable, or meet one of the conditions in 130 CMR 425.417(B). Members who are younger than 21 years old must also be reviewed by a screening team prior to the 30th day after admission and every 30 days thereafter.
(B) Additional Conditions. The following additional conditions qualify a member 21 years of age or older to continue to receive psychiatric inpatient hospital services, even if the member does not qualify under 130 CMR 425.417(A):
(1) the persistence
of conditions that necessitated admission, despite therapeutic efforts, or the
emergence of additional problems consistent with the admissions criteria in
130 CMR
425.406 or
425.407;
(2) a severe reaction to medication;
or
(3) a need for stabilization of
psychiatric conditions, integration of gains, or preparation for transition to
outpatient care or a residential setting.
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