This section defines services that are not reimbursable as behavioral health stabilization services under DC Medicaid rules, including room and board, inpatient hospital services, transportation, educational/vocational services, services by family members, social/recreational services, non-medically necessary services, and services not documented per certification standards. Facility operators must ensure that only covered behavioral health stabilization services are billed and that all services are medically necessary, properly documented, and directed to the individual's benefit.
View official source8030 NON-REIMBURSABLE SERVICES 8030.1 Services not covered as behavioral health stabilization services include, but are not limited to: (a) Room and board residential costs; (b) Inpatient hospital services, including hospital, nursing facility, intermediate care facility for individuals with intellectual disabilities, and institutions for mental diseases; (c) Transportation services; (d) Educational, vocational, and job training services; (e) Services rendered by parents or other family members; (f) Social or recreational services; (g) Universal screening and prevention services (other than those provided under Early and Periodic Screening, Diagnosis, and Treatment requirements); (h) Services that are not medically necessary; (i) Services that are not provided and documented in accordance with these certification standards; (j) Services that are not behavioral health stabilization services as described in these rules; and (k) Services furnished to persons other than the individual, when those services are not directed primarily to the well-being and benefit of the individual. SOURCE: Final Rulemaking published at 68 DCR 1623 (February 5, 2021). District of Columbia Municipal Regulations Mental Health 22-A DCMR § 8030