Regulation detail

29-5211

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29-5211 PSYCHOSOCIAL REHABILITATION SERVICES/CLUBHOUSE

Jurisdiction: DC Agency: DC Department of Behavioral Health (DBH) — Title 22-A; and DC Department of Health Care Finance (DHCF) — Title 29 Medicaid behavioral-health chapters
CMHC (60%)
Plain-English summary

This regulation governs Medicaid billing and service delivery requirements for Psychosocial Rehabilitation (Clubhouse) services in DC, which use behavioral, cognitive, and supportive interventions to help individuals with mental health diagnoses develop community living and employment skills. Services must be billed in 15-minute units with a daily maximum of 24 units, and must follow standards in Title 22-A DCMR Chapters 34 and 39. Clubhouse services may not be billed on the same day as Rehabilitation Day Services, other Medicaid day treatment services, or while a consumer is enrolled in Intensive Day Treatment (IDT).

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Regulation text
5211 PSYCHOSOCIAL REHABILITATION SERVICES/CLUBHOUSE

5211.1 Psychosocial Rehabilitation (“Clubhouse”) services utilize behavioral, cognitive, and supportive interventions to assist individuals with mental health diagnoses to develop social networking, independent living, budgeting, self-care, and other skills that will assist them to live in the community and to prepare for securing and retaining employment. 

5211.2 Clubhouse services shall be billed in fifteen (15) minute units. A maximum of twenty-four (24) units may be billed in a day. 
 
5211.3 Clubhouse services shall be delivered in accordance with the requirements set forth in Chapters 34 and 39 of Title 22-A DCMR. 

5211.4 Clubhouse shall not be billed on the same day as Rehabilitation Day Services or other Medicaid covered day treatment services. Clubhouse shall not be billed while a consumer is enrolled in IDT.

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 § 5211