This section establishes eligibility requirements for reimbursement of Mental Health Rehabilitation Services (MHRS) provided to Department consumers in the District of Columbia. Only certified MHRS providers with a Health Care Agreement (HCA) who have delivered specified services may bill the Department. Certain service codes (MHS-CTPI, MHS-DTPI, and CPS-Rehab/Day) require prior authorization from the Department before or after a defined threshold of billed units.
View official source5303 ELIGIBILITY 5303.1 Only a certified MHRS provider with an HCA that has provided one of these identified services to a Department consumer may be reimbursed for services billed to the Department under this chapter. 5303.2 Reimbursement for MHS-CTPI requires prior authorization from the Department after 24 units billed within 180 days. 5303.3 Reimbursement for MHS-DTPI, MHS-DTPI (ACT), MHS-DTPI (CBI) and CPS-Rehab/Day requires prior authorization from the Department. SOURCE: Final Rulemaking published at 61 DCR 3787 (April 11, 2014). District of Columbia Municipal Regulations Mental Health 22-A DCMR § 5303