Regulation detail

29-5230

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29-5230 ELIGIBILITY REQUIREMENTS

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%) OUTPATIENT (60%)
Plain-English summary

This section establishes eligibility requirements for Mental Health Rehabilitation Services (MHRS) billed under Title 29 Medicaid provisions, limiting coverage to Medicaid recipients who also meet the requirements set forth in the corresponding Title 22-A DCMR chapters governing MHRS. Facility operators and billing entities must verify that clients hold active Medicaid enrollment and satisfy the clinical eligibility criteria referenced in Chapters 34 and 39 of Title 22-A before submitting claims under this chapter.

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Regulation text
5230 ELIGIBILITY REQUIREMENTS

5230.1 Only persons who are Medicaid recipients and meet the requirements set forth in Chapter 34 and Chapter 39 of Title 22-A DCMR shall be eligible to receive MHRS services billed under this Chapter.

SOURCE: Final Rulemaking published at 72 DCR 013719 (December 5, 2025).

District of Columbia Municipal Regulations

 Public Welfare
29 DCMR § 5230