Ill. Admin. Code tit. 89, § 140.452 - Community-based Mental Health Providers Qualified for Payment
a) Payment will be made for community-based
mental health services provided by providers enrolled in the Illinois Medical
Assistance Program as:
1) A Community Mental
Health Center. Community Mental Health Center shall mean an entity certified by
the Department, or its agent, pursuant to 59 Ill. Adm. Code 132; or
2) A Behavioral Health Clinic, pursuant to
Section
140.499;
or
3) An Independent Practitioner
defined as:
A) A Licensed Clinical
Psychologist, pursuant to 89 Ill. Adm. Code
140.423(a);
B) A Licensed Clinical Social Worker,
pursuant to 89 Ill. Code
140.424(a);
or
C) A psychiatrist, defined as a
physician licensed under the Medical Practice Act of 1987 who has successfully
completed a training program in psychiatry approved by the Accreditation
Council for Graduate Medical Education (ACGME) or other training program
identified as equivalent by the Department.
b) To receive payment for community-based
mental health services, providers must be enrolled for participation in the
Medical Assistance Program, pursuant to Sections
140.11
and
140.12.
c) Community Mental Health Centers may
receive reimbursement for all services described in Section
140.454.
d) Behavioral Health Clinics may receive
reimbursement for all services described in Section 140.454, except Behavioral
Health Clinics may not receive reimbursement for the services described in the
following subsections of Section
140.453:
Assertive Community Treatment (Section
140.453(d)(4)(A)
) and Psychosocial Rehabilitation (Section
140.453(d)(2)(F)
).
e) Independent Practitioners may
receive reimbursement only for the following services: Integrated Assessment
and Treatment Planning (Section
140.453(d)(1)
); Therapy/Counseling (Section
140.453(d)(2)(G)
); and MRO Crisis Services (Section
140.453(d)(3)
).
Notes
Amended at 28 Ill. Reg. 15513, effective November 24, 2004
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