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Revised: August 5,


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Revised: May 12, Substance use disorder SUD services include assessment of needs, treatment planning and interventions to address client needs as a result of substance use. Effective Oct. Beginning July 1,there will no longer be a service agreement process, Direct Access will be the only way to access SUD services.

The federal demonstration, through the implementation of ASAM criteria, seeks to enhance evidence-based assessment and placement criteria for the purpose of matching individual risk with the appropriate ASAM level of care. The demonstration also increases standards for treatment coordination to ensure transitions to needed services across a comprehensive continuum of care.

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If an individual has not yet been determine financially eligible but has SUD treatment needs, they may access services through Behavioral Health Fund BHF if they meet clinical and financial eligibility requirements:. Covered services must be delivered as outlined in the Minnesota Statutes listed under Legal References.

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Providers must be enrolled with MHCP as an eligible provider of specific services, specialties or complexity add-ons to receive reimbursement from MHCP. Providers are responsible for knowing and understanding the rules and regulations pertaining to any services they submit for reimbursement. The following are not eligible for the demonstration residential rate enhancement: hospitals and Withdrawal Management services.

Provider manual

MAT services are reimbursed on a per diem basis and may also be included as an add-on to the residential treatment service per diem. Participating demonstration providers d as residential SUD programs must offer medication-assisted treatment services on site or facilitate access to medication-assisted treatment services off site. MAT may include:. When providers are paid an encounter rate, encounter payments are not available for self-administered medication.

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Service Description. Nonresidential programs H is used for individual counseling and H HQ is used for group treatment services provided in their respective settings. Unit of time is attained when the mid-point is passed, and more than half of the time must be spent performing the service for reporting a specific code, excluding any breaks.

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Residential programs H is a per diem code used for treatment program services in a residential setting. Accordingly, the 30, 15 and five hours of clinical services required for the respective intensity level must be provided based on an actual count of continuous minutes of treatment service provided. Breaks may not be included in these continuous minutes.

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Coordinate services for MCO enrollees with their health plans. Room and Board are carved out from MCO plans. Bill treatment services to the plan and bill room and board to MHCP as follows:.

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Bill freestanding or residential program room-and-board charges revenue codes or that are authorized by the MCO directly to MHCP. Do not bill for services that require MCO authorization or services that are in an appeal process until the services are authorized.

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Bill residential and inpatient hospital claims that span multiple months using interim billing method. Include the date of discharge on the final treatment claim along with appropriate patient status code. Report the appropriate place of service to distinguish on-site dosage s from take-home dosage s.

Itemize dosages by listing each date of service on a separate service line. Report this. Find in Table of Contents:.