5253440 Behavioral Health, Department of - Notice of Proposed Rulemaking - Amendment to the local reimbursement rates for substance use disorder services

DEPARTMENT OF BEHAVIORAL HEALTH

 

NOTICE OF PROPOSED RULEMAKING

 

The Director of the Department of Behavioral Health (Department), pursuant to the authority set forth in Sections 5113, 5115, 5117 and 5118 of the Department of Behavioral Health Establishment Act of 2013, effective December 24, 2013 (D.C. Law 20-61; D.C. Official Code §§ 7-1141.02, 7-1141.04, 7-1141.06 and 7-1141.07, respectively, (2014 Supp.)), hereby gives notice of a proposed amendment to  Chapter 62, “Reimbursement Rates for Services Provided by the Department of Behavioral Health - Certified Substance Abuse Providers” in Subtitle A (Mental Health) of Title 22 (Health) of the District of Columbia Municipal Regulations (DCMR).

 

The purpose of this amendment is to update the reimbursement rates for services provided to eligible District residents by Department-certified substance abuse treatment facilities and programs which have an active Human Care Agreement with the Department to provide such services.  The revised rates have been updated generally to align them with the reimbursement rates for mental health services provided by Department-certified mental health providers, which were revised after a thorough rate review.    The rules are also being amended to add a rate for a new evidence-based service, Multisystemic Therapy for Juveniles (ACRA), now available to children, youth and young adults receiving substance use disorder treatment services.   Finally, the code for toxicology specimen collection has been separated for the type of specimen collection (breathalyzer or urinalysis) and for the laboratory analysis of the urinalysis specimen.   

 

The Director gives notice of the intent to take final rulemaking action to adopt the proposed rules in not less than thirty (30) days after the date of publication of this notice in the D.C. Register. 

 

Section 6201 of Chapter 62, REIMBURSEMENT RATES FOR SERVICES PROVIDED BY THE DEPARTMENT OF BEHAVIORAL HEALTH – CERTIFIED SUBSTANCE ABUSE PROVIDERS, of 22-A DCMR, MENTAL HEALTH, is amended by deleting it in its entirety and replacing it with the following:

 

6201                REIMBURSEMENT RATE

 

6201.1             Reimbursement for substance abuse services shall be as follows:

 

SERVICE	CODE	RATE per        UNIT
Urinalysis (Laboratory)	H0003	15.00
Breathalyzer Collection	H0048	8.80
Urinalysis Collection	H0048 LR	8.80
Case Management	H0006	20.02
Case Management (HIV)	H0006V9	20.02
Treatment Planning	T1007	22.00
Treatment Planning - Complex IP	T1007TG	24.00
Targeted Case Management (Clinical Care Coordination)	T1017HF	22.50
Counseling Group	H0005	10.45
Counseling Group - Psycho-educational	H2027	3.51
Counseling Group - Psycho-educational (HIV)	H2027V9	3.51
Counseling On-site - Behavioral Health Therapy	H0004	26.42
Counseling, Off-site	H0004HFTN	27.45
Counseling, Family with Client	H0004HR	26.42
Counseling, Family without Client	H0004HS	26.42
Crisis Intervention	H0007HF	36.93
CS Peer Support Group - Substance Abuse	H0038HFHQ	6.65
CS Peer Support - Substance Abuse	H0038HF	21.97
Detoxification - Outpatient - Ambulatory	H0014	24.53
Detoxification - Residential - Acute care	H0010	605.00
Behavioral Health Screening - Determine eligibility	H0002HF	85.34
Behavioral Health Screening - Evaluate Risk Rating	H0002TG	140.00
Diagnostic Assessment - Indepth - Adult	H0001HF	256.02
Diagnostic Assessment - Ongoing - Modify Tx Plan	H0001TS	85.34
Diagnostic Assessment - In-depth Exam - Youth	H0001HA	256.02
Diagnostic Assessment - Ongoing Follow-up - Youth	H0001HATS	85.34
Intensive Outpatient - All Inclusive	H0015	74.25
Intervention - Substance Abuse Recognition	H0022	27.17
Dose - Methadone - Clinic or Take-Home	H0020	8.58
Medication Assisted Therapy	H0020HF	8.58
Medication Management - Adult	H0016HF	44.65
Medication Management - Youth	H0016HAHF	44.65
Multisystemic Therapy for Juveniles (ACRA) (ages 21 – 24)	H2033HF	57.42
Multisystemic Therapy for Juveniles (ACRA) (ages 12 – 20)	H2033HAHF	57.42
Outpatient Therapy - Intensive	H0015HA	164.61
Prenatal Care, at-risk Assessment	H1000	142.56
Prenatal Care, at-risk enhanced service - Ante-partum Management	H1001	80.08
Prenatal Care, at-risk enhanced service - Care Coordination	H1002	80.08
Prenatal Care, at-risk enhanced service - Education	H1003	80.08
Prenatal Care, at-risk enhanced service - follow-up Home Visit	H1004	100.76
Residential - Long term Therapeutic	H0019	132.55
Residential - Long term Room & Board	H0043	72.90
Residential – Youth Room and Board	H0043HA	167.40
Residential Treatment - Inclusive	H0018	136.84
Residential Treatment – Inclusive (Youth)	H0018HA	197.60
Residential Treatment – Inclusive (HIV)	H0018V9	136.84
Residential Per Diem - Women w/1 child	H0043UN	210.00
Residential Per Diem - Women w/2 children	H0043UP	215.00
Residential Per Diem - Women w/3 children	H0043UQ	220.00
Residential Per Diem - Women w/4 or more  children	H0043UR	225.00
2010 Recovery Support Evaluation	2010	85.00
2090 Family and Marital Services - Individual	2090	140.00
2091 Family and Marital Services  - Group	2091	50.00
3010 Parenting Services – Individual	3010	90.00
3011 Parenting Services – Group	3011	50.00
3020 Child Care (1 – 2 Children)	3020	15.00
3021 Child Care (3 or more children)	3021	30.00
3040 Care Coordination	3040	35.00
3051 Transportation (Public)	3051	65.00
4050 Environmental Stability – Individual	4050	212.25
4051 Environmental Stability – Women w/children	4051	250.00
5030 Recovery Mentoring/Coaching	5030	75.00
5040 Life Skills – Individual	5040	45.00
5041 Life Skills (Group Adult)	5041	25.00
5041 Life Skills (Group – Youth)	5041	50.00
5050 Spiritual Support Group	5050	50.00
6020 HIV/AIDS Education	6020	25.00
6030 Education Services – Individual	6030	75.00
6031 Education Services – Group	6031	50.00

 

 

 

All persons desiring to comment on the subject matter of this proposed rulemaking should file comments in writing not later than thirty (30) days after the date of publication of this notice in the D.C. Register.  Comments should be filed with the Suzanne Fenzel, Deputy Director, Office of Strategic Planning, Policy and Evaluation, Department of Behavioral Health, at 64 New York Ave., NE, 3nd Floor, Washington, D.C. 20002, or e-mailed to [e-mail].  Copies of the proposed rules may be obtained from dbh.dc.gov or from the Department of Behavioral Health at the address above.