La. Admin. Code tit. 50 § XV-9303

Current through Register Vol. 50, No. 11, November 20, 2024

Section XV-9303 - Covered Services

A. The medical necessity for these rehabilitative services must be determined by, and services recommended by, a licensed mental health practitioner, or as ordered by a staff physician.

B. Outpatient Treatment Program

1. Professionally directed assessment, diagnosis, treatment, and recovery services are provided in an organized non-residential treatment setting by licensed mental health practitioners (LMHPs) and non-licensed professionals under the supervision of a LMHP.

2. Outpatient treatment program hours range from one hour to nine hours/week. The maximum level of hours may be exceeded based on medical necessity.

3. Outpatient treatment program services include, but are not limited to:

a. individual, group, and family counseling;

b. medication compliance;

c. relapse prevention; and

d. disease concept.

4. Outpatient treatment program services offer comprehensive, coordinated, and defined services that may vary in level of intensity.

C. Intensive Outpatient Treatment Program

1. Professionally directed assessment, diagnosis, treatment, and recovery services are provided in an organized non-residential treatment setting by LMHPs and non-licensed professionals under the supervision of a LMHP.

2. Adolescents in intensive outpatient treatment programs receive a minimum of six hours/week with no specified frequency/week. The maximum is up to 20 hours/week. The maximum level of hours may be exceeded based on medical necessity.

3. Intensive outpatient treatment program services include, but are not limited to:

a. individual, group, and family counseling; and

b. education on recovery.

4. Intensive outpatient treatment program services offer comprehensive, coordinated, and defined services that may vary in level of intensity.

5. These services consist of a scheduled series of face-to-face sessions appropriate to the individual's plan of care.

La. Admin. Code tit. 50, § XV-9303

Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 38:2371 (September 2012).

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.