This regulation establishes Medicaid reimbursement rules for Screening, Assessment, and Diagnostic Services within DC's Mental Health Rehabilitation Services (MHRS) program. It specifies billing units and frequency limits for screenings and assessments, including when assessments must occur (e.g., at start of MHRS, upon level-of-care changes, or every 90 days). Assertive Community Treatment (ACT) providers face additional restrictions on billing these services. Providers must also comply with clinical delivery standards set forth in Chapter 34 of Title 22-A DCMR.
View official source5202 SCREENING, ASSESSMENT, AND DIAGNOSTICS 5202.1 Screening, Assessment, and Diagnostic Services include the following services: Screening; Initial Assessment; Comprehensive Diagnostic Assessment; and Ongoing Diagnostic Assessment. 5202.2 Services shall be reimbursed as follows: Screening shall be reimbursed in five (5) minute units. A maximum of three (3) units may be billed during a single screening; Assessments shall: (1) Be an average duration of sixty (60) minutes. A maximum of one (1) unit may be billed per occurrence; (2) Be rendered: (A) Upon the start of MHRS; (B) No more than once every ninety (90) days thereafter; (C) When a change in level of care occurs; or (D) Prior to a determination that MHRS is no longer needed. 5202.3 Screening, Assessment and Diagnostic services shall be delivered in accordance with the requirements set forth in Chapter 34 of Title 22-A DCMR. 5202.4 An ACT provider shall only be permitted to bill Screening, Assessment, and Diagnostic services if the ACT provider’s assessment determines ACT services are not indicated for the consumer, otherwise, the ACT provider should bill for ACT services. SOURCE: Final Rulemaking published at 49 DCR 4860 (May 24, 2002); as amended by Final Rulemaking published at 69 DCR 012836 (October 21, 2022); as amended by Final Rulemaking published at 72 DCR 013719 (December 5, 2025). District of Columbia Municipal Regulations Public Welfare 29 DCMR § 5202