Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 434.000 - Psychiatric Hospital Outpatient Services
Section 434.402 - Definitions

The following terms used in 130 CMR 434.000 have the meanings given in 130 CMR 434.402 unless the context clearly requires a different meaning.

Child and Adolescent Needs and Strengths - a tool that provides a standardized way to organize information gathered during behavioral-health clinical assessments. A Massachusetts version of the tool has been developed and is intended to be used as a treatment decision support tool for behavioral-health providers serving MassHealth members under the age of 21.

Couple Therapy - for the purposes of mental health services, therapeutic services provided to a couple whose primary complaint is the disruption of their marriage, family, or relationship.

Crisis Intervention/Emergency Services - immediate mental health evaluation, diagnosis, hospital prescreening, treatment, and arrangements for further care and assistance as required, provided during all hours to members showing sudden, incapacitating emotional stress.

Diagnostic Services - for the purposes of mental health services, the examination and determination of a patient's psychological, social, economic, educational, and vocational assets and disabilities for the purpose of designing a treatment plan.

Family Consultation - a preplanned meeting with a parent, foster parent, legal guardian, or caretaker of a child or adolescent who is being treated, when the parent, foster parent, legal guardian, or caretaker is not the focus of the meeting.

Family Therapy - for the purposes of mental health services, the treatment of more than one member of a family simultaneously in the same session.

Group Therapy - for the purposes of mental health services, the application of psychotherapeutic or counseling techniques to a group of persons, most of whom are not related by blood, marriage, or legal guardianship.

Individual Therapy - for the purposes of mental health services, a therapeutic service provided to an individual.

Institutionalized Individual - an individual who is either

(1) involuntarily confined or detained under a civil or criminal statute in a correctional or rehabilitative facility, including a psychiatric hospital or other facility for the treatment of mental illness; or

(2) confined under a voluntary commitment in a psychiatric hospital or other facility for the care and treatment of mental illness.

Maintenance Therapy - repetitive therapy that is performed when a person can progress no further toward functional independence but that is or may be necessary to prevent regression.

Medication Visit - for the purposes of mental health services, a member visit specifically for the prescription, review, and monitoring of medication by a licensed psychiatrist or licensed clinician with prescriptive authority or for the administration of prescribed intramuscular medication by a licensed nurse or physician.

Mental Illness - mental and emotional disorders as defined in the current American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disease, 4th edition (DSM-IV).

Psychiatric Hospital Outpatient Services - services provided to members on an outpatient basis in a psychiatric inpatient hospital.

Psychiatric Inpatient Hospital - any psychiatric facility or inpatient program in a licensed psychiatric facility that has six beds or more for inpatient use, is certified by the Massachusetts Department of Public Health for participation in Medicare, and primarily treats patients whose principal diagnosis is based on the DSM-IV. For out-of-state psychiatric inpatient hospital providers, certification for participation in MassHealth by the appropriate state agency may be substituted. "Primarily treats" means that, over a six-month period, inpatient care has been provided to a patient population of which 51% or more consistently have a principal diagnosis that is psychiatric.

Psychiatric Outpatient Visit - a psychiatric hospital outpatient service involving a face-to-face encounter between an eligible member and a licensed practitioner for diagnosis, examination, or treatment.

Psychological Testing - the use of standardized test instruments by a licensed psychologist to evaluate aspects of an individual's functioning, including aptitudes, educational achievements, cognitive processes, emotional conflicts, and type and degree of psychopathology, subject to the limitations of 130 CMR 434.480(H).

Short-term Therapy - for the purposes of mental health services, a combination of diagnostics and individual, couple, family, and group therapy planned to end within 12 sessions.