Section 7 AAC 135.110 - Professional behavioral health assessments(a) If an individual requests treatment, or is referred by a court or other agency, as an individual who is suspected of having a behavioral health disorder that could require behavioral health services, the department will pay (1) a community behavioral health services provider for the following services: (A) one of the following behavioral health intake assessments: (i) a mental health intake assessment under (b) of this section;(ii) a substance use intake assessment under (c) of this section;(iii) an integrated mental health and substance use intake assessment under (d) of this section;(B) a psychiatric assessment under (e) of this section;(C) psychological testing and evaluation under (g) of this section;(2) a mental health physician clinic for (A) a mental health intake assessment under (b) of this section;(B) a psychiatric assessment under (e) or (f) of this section;(C) psychological testing and evaluation under (g) of this section.(D) an integrated mental health and substance use intake assessment under (d) of this section.(b) To qualify for payment, a mental health intake assessment must be (1) documented in the recipient's clinical record in accordance with 7 AAC 105.230 and 7 AAC 135.130;(2) conducted in accordance with (A) the requirements of 7 AAC 135.010(b)(1), if the provider is a community behavioral health services provider;(B) the requirements of 7 AAC 135.030(d), if the provider is a mental health physician clinic;(3) conducted upon admission to services and during the course of active treatment as necessary, for the purpose of determining and documenting (A) the recipient's mental status and social and medical history;(B) the nature and severity of any identified mental health disorder;(C) a diagnosis consistent with the (i)Diagnostic and Statistical Manual of Mental Disorders, adopted by reference in 7 AAC 160.900;(ii)International Classification of Diseases, adopted by reference in 7 AAC 160.900; or (iii)Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: Revised Edition (DC:0-3R), adopted by reference in 7 AAC 160.900;(D) treatment recommendations that form the basis of a subsequent behavioral health treatment plan; and(E) functional impairment; and(4) updated as new information becomes available.(c) To qualify for payment, a substance use intake assessment must be (1) documented in the recipient's clinical record in accordance with 7 AAC 105.230 and 7 AAC 135.130;(2) conducted at a minimum by a substance use disorder counselor, behavioral health clinical associate, or other qualified program staff member performing duties regularly within the scope of the individual's training, experience, and education; however, if the substance use intake assessment is conducted as part of withdrawal management services subject to 7 AAC 70.110 and 7 AAC 135.190, the assessment must be conducted by an individual identified in 7 AAC 70.110 for the type of withdrawal management service provided;(3) conducted upon admission to services and during the course of active treatment as necessary, for the purpose of determining and documenting (A) if the recipient has a substance use disorder;(B) the nature and severity of any identified substance use disorder;(C) the correct diagnosis;(D) treatment recommendations that form the basis of a subsequent behavioral health treatment plan; and(E) functional impairment; and(4) updated as new information becomes available.(d) To qualify for payment, an integrated mental health and substance use intake assessment must (1) be documented in the recipient's clinical record in accordance with 7 AAC 105.230 and 7 AAC 135.130;(2) be conducted in accordance with (A) the requirements of 7 AAC 135.010(b)(1), if the provider is a community behavioral health services provider;(B) the requirements of 7 AAC 135.030(d), if the provider is a mental health physician clinic;(3) meet the requirements of (b)(3) and (c)(3) of this section; and(4) be updated as new information becomes available.(e) The department will pay a community behavioral health services provider or mental health physician clinic for a psychiatric assessment interview, that is to serve as the professional behavioral health assessment under this section, if the recipient's condition indicates the need for a more intensive assessment, including an assessment to evaluate the need for medication. A psychiatric assessment interview must (1) be conducted by a professional described in 7 AAC 135.010(b) (2);(2) include a review of any general medical and psychiatric history or problem the recipient is presenting;(3) include a relevant recipient history;(4) include a mental status examination;(5) result in a diagnosis consistent with the (A)Diagnostic and Statistical Manual of Mental Disorders, adopted by reference in 7 AAC 160.900;(B)International Classification of Diseases, adopted by reference in 7 AAC 160.900; or (C)Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: Revised Edition (DC:0-3R), adopted by reference in 7 AAC 160.900;(6) include a listing of any identified psychiatric problems, including functional impairments, with treatment recommendations.(g) The department will pay a community behavioral health services provider, mental health physician clinic, or psychologist for psychological testing and evaluation to assist in the diagnosis and treatment of mental and emotional disorders. Psychological testing and evaluation includes the assessment of functional capabilities, the administration of standardized psychological tests, and the interpretation of findings, and must be conducted in accordance with (1) the requirements of 7 AAC 135.010(b) (1), if the provider is a community behavioral health services provider;(2) the requirements of 7 AAC 135.030(d) and (e), if the provider is a mental health physician clinic;(3) the requirements of 7 AAC 135.030(a), if the provider is a psychologist.Eff. 10/1/2011, Register 199; am 6/16/2016, Register 218, July 2016; am 11/10/2019, Register 232, January 2020; am 4/24/2020, Register 234, April 2020Authority:AS 47.05.010
AS 47.07.030