This regulation defines Medicaid reimbursement requirements for Counseling/Therapy services under DC's behavioral health program, covering individual, group, and family modalities. Services must be face-to-face, billed per occurrence based on time, and may be delivered on-site or off-site. The rule cross-references Chapter 34 of Title 22-A DCMR for delivery standards and restricts same-day billing with certain other services, as well as billing while a consumer is enrolled in ACT.
View official source5204 COUNSELING/THERAPY 5204.1 Counseling/Therapy services shall include: Individual Counseling/Therapy; Group Counseling/Therapy; and Family Counseling/Therapy. 5204.2 Counseling/Therapy services shall: Consist of a face-to-face encounter; Be reimbursed on a per-occurrence basis, dependent on the amount of time spent providing the service; and Be provided on-site or off-site, or in individual or group interventions. 5204.3 Counseling/Therapy services shall be delivered in accordance with the requirements set forth in Chapter 34 of Title 22-A DCMR. Counseling/Therapy services shall not be billed on the same day as CBI, CPP, IDT, FFT, MST, TF-CBT, TST, or Trauma Recovery and Empowerment Services. Counseling/Therapy services shall not be billed while a consumer is enrolled in ACT, unless otherwise authorized by DBH. 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 § 5204