La. Admin. Code tit. 50 § XXXIII-6307

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

Section XXXIII-6307 - Covered Services

A. The following mental health services shall be reimbursed under the Medicaid Program:

1. therapeutic services delivered by licensed mental health professionals (LMHPs), provisionally licensed professional counselors (PLPC), provisionally licensed marriage and family therapists (PLMFT), or licensed master social workers (LMSW), and physicians;

2. rehabilitation services, including community psychiatric support and treatment (CPST), psychosocial rehabilitation (PSR), and peer support services;

3. crisis intervention; and

4. crisis stabilization.

B. Service Exclusions. The following shall be excluded from Medicaid reimbursement:

1. components that are not provided to, or directed exclusively toward the treatment of, the Medicaid eligible individual;

2. services provided at a work site which are job tasks oriented and not directly related to the treatment of the recipients needs; and

3. any services or components in which the basic nature of which are to supplant housekeeping, homemaking, or basic services for the convenience of an individual receiving services.

La. Admin. Code tit. 50, § XXXIII-6307

Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 38:359 (February 2012), Amended by the Department of Health and Hospitals, Bureau of Health Services Financing and the Office of Behavioral Health, LR 4261 (1/1/2016), Amended by the Department of Health, Bureau of Health Services Financing and the Office of Behavioral Health, LR 441015 (6/1/2018), Amended LR 46795 (6/1/2020), Repromulgated LR 46952 (7/1/2020), Amended LR 461680 (12/1/2020), Amended LR 481098 (4/1/2022), Amended LR 50984 (7/1/2024).

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