AHCCCS 801 E Jefferson St Phoenix, Az 85034 Find Us On Google Maps. The information in this chapter does not apply to members enrolled in Healthy Montana Kids (HMK). h��T�K�q�w��]��k�$�tY9�����7��%�u���b��D��A{�Bp�e�+hV�. An email, letter, voicemail or text alone does not meet the requirement for monthly personal contact. Nevada Medicaid Behavioral Health is a part of the Policy Development & Program Management unit that oversees policies for rehabilitative mental health, substance abuse prevention and treatment, targeted case management, inpatient psychiatric services… Behavioral Health Provider Manual; Instructions for Completing CareConnection® High Intensity (tiered) Instructions for Completing the CareConnection® for Private Practitioners (tiered) Attention All Providers: Requirements on When to Use the National Provider Identifier (NPI) of an Ordering, Prescribing or Referring (OPR) Provider … A person receiving BHH services has been determined to be eligible for ARMHS. Comprehensive care management is a collaborative process designed to manage medical, social and behavioral health conditions more effectively based on population health data and tailored to the person. HCA is committed to providing equal access to our services. PLEASE NOTE: Differences in State Medicaid rules can vary greatly, please confirm information with Montana Medicaid. 2 . The behavioral health home (BHH) services model of care utilizes a multidisciplinary team to deliver person-centered services designed to support a person in coordinating care and services while reaching his or her health and wellness goals. Behavioral health home services provider “A” is also certified to provide ARMHS. Providers should contact the MCO directly to learn what procedures the MCO will use to ensure no duplicate payment. Utah Medicaid Provider Manual Rehabilitative Mental Health and Substance Use Disorder Services Division of Medicaid ... Behavioral health services means the rehabilitative services directed to the treatment of the mental ... federally qualified health center (FQHC). found in other chapters of the BMS Provider Manual. Lifetime limit of six payments in enrollee’s lifetime. It is critical that the provider and the provider’s staff be familiar with, and comply with, all information contained in the General Billing Manual – Volume I, and this Provider Specific Billing Manual – Volume II. All discontinued manuals no longer contain active information … Behavioral health home services applicants and certified providers may request a variance on specific service requirements. ... CTSS mental health behavioral aide). • failure to grant the variance would result in hardship to the provider. Example 2 MHCP uses provider service and utilization information to identify those providers who are considered to have a similar caseload to that of the new center or clinic. An individual may receive no more than six payments at the enhanced rate per member per month. The rate for behavioral health home services is a per member per month payment. Federally Qualified Health Centers . Care coordination occurs when the BHH services team acts as the central point of contact in the compilation, implementation and monitoring of the individualized health action plan through appropriate linkages, referrals, coordination and follow-up to needed services and supports. • The BHH services provider confirms and documents the person has a diagnosis from a qualified health professional within the previous 12 months that indicates the person has a condition that meets the federal definition of serious mental illness (adults) or emotional disturbance (children). The Fee-For-Service (FFS) Provider Billing Manual is intended to outline billing requirements for providers who are billing the AHCCCS FFS unit for reimbursement. See BHH MCO Contact Information. These factors impact holistic health, including but not limited to, medical and behavioral health care, entitlements and benefits, respite, housing, transportation, legal services, educational, employment services and financial. Federally Qualified Health Center (FQHC) Behavioral Health Services Provider Manual 07/01/19 Edition Posted 07/01/19 . If the person has a current DA in place (current means within the past 12 months), another DA is not needed at the time the person starts BHH services nor within six months of enrollment into BHH services. Minnesota Statutes 256B.0757 Coordinated Care through a Health Home Welcome to the State of Nevada Division of Health Care Financing and Policy (DHCFP) Behavioral Health Services (BHS) webpage. ... Revised Provider Manual . For purposes of eligibility for BHH services, one of the following types of diagnostic assessment is allowable: Assessments must be performed according to requirements outlined in the Diagnostic Assessment section of the MHCP Provider Manual. During the initial 90-day engagement period, a staff member of the BHH services team must have contact with the person to: Individuals eligible for behavioral health home services are eligible for all MA-covered services. Health & Human Services (HHS) allows such a grant, which qualifies the entity as an “FQHC look-alike” based on a Health Resources and Services Administration (HRSA) recommendation Treated by the Secretary of HHS as a comprehensive Federally funded health center as of January 1, 1990, for purposes of Medicare Part B BHH services providers must have the capacity to deliver the following six core services based on the individual’s needs and in accordance with the BHH Certification Standards (DHS-6766-ENG) (PDF). BHH services providers should use the diagnostic code(s) that corresponds with the person’s mental health diagnosis that established the person’s eligibility for BHH services. endstream endobj startxref MHSP services are allowed for RHCs and FQHCs. Federally Qualified Health Centers (FQHC) and Rural Health Clinics ... to a new FQHC or RHC. Behavioral Health Provider Manual. To become certified, FQHC’s self-attest to their compliance with Medicare conditions for coverage [under ... o Behavioral Health Services o Other specialty services (specify service, e.g. • Have personal contact with the person or the identified support at least once per month. ... • Behavioral and Medical Health Care Home claim procedure codes S0280 and S0281. The BHH services provider organization is permitted to bill for both services as long as the provider organization has met the billing requirements for each service. Download Entire Manual . PMHP authorization is not required. • The BHH services provider confirms that the member has current MA coverage. A person receiving BHH services has been determined to be in need of asthma education. DHS may grant a variance from the requirements when: To request a variance, a provider will have to complete and submit the BHH services Variance Request (DHS-8026) (PDF) for review and approval. Federally Qualified Health Center Service – A medical, dental or allied health service provided by FQHC personnel and services and supplies incident to such services provided by FQHC … CCBHC mental health certified family peer specialist services are subject to the same standards outlined in the Mental Health Certified Family Peer Specialist section of the MHCP Provider Manual. The electronic Medicaid Provider Manual contains coverage, billing, and reimbursement policies for Medicaid, Healthy Michigan Plan, Children's Special Health Care Services, Maternity Outpatient Medical Services (MOMS), and other healthcare programs administered by the Michigan Department of Health and Human Services (MDHHS). BHH services providers must determine and document an individual’s eligibility before providing and billing for BHH services. FQHC Behavioral Health Billing Codes FQHC Providers are reimbursed at PPS rate for all threshold visits regardless of service code for Medicaid visits. This publication takes effect July 1, 2019 and supersedes earlier Montana ... Behavioral Health Services Policy change Visiting Nurses Removed RHC-only reference Clarification, per 42 CFR 2416 Department of Health and Human Services (DHHS), also referred to as the Department. 4112 0 obj <>/Filter/FlateDecode/ID[<9395CECA188EC744A2FCE04060EFC024>]/Index[4097 27]/Info 4096 0 R/Length 90/Prev 723680/Root 4098 0 R/Size 4124/Type/XRef/W[1 3 1]>>stream BILLING AND POLICY MANUAL FQHC and RHC Services U PDATED December 20 PAGE | 1 FQHC AND RHC SERVICES . Subsequent claims in the same calendar month for one of the identified duplicate services will not be paid. Indian tribes may change to an FQHC classification if they have Public Law 93-638 status. Federally qualified health center (FQHC) behavioral health services provider manual. Adherence to the service delivery requirements will be monitored as part of ongoing certification. ... Read the behavioral health manual. CR 11575 revises Medicare Benefit Policy, Chapter 13 (Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) Services) to clarify payment and other policy information. %%EOF BHH services providers are required to communicate and coordinate with MCOs to ensure that services and activities are coordinated to most effectively meet the goals of the person and to ensure that duplication between the MCO and the BHH services provider is avoided. About this Manual . contract or agreement with an RHC provides medical, behavioral or dental services for the patients of the RHC. orthopedics, podiatry) Minnesota Statutes 245.461 to 245.468, Minnesota Comprehensive Adult Mental Health Act The term “behavioral health home” services refers to a model of care focused on integration of primary care, mental health services, and social services and supports for adults diagnosed with mental illness or children diagnosed with emotional disturbance. 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