Section He-M 426.07 - Medication-Related Services(a) Administration of medication by injection shall: (1) Be a covered CMHP service;(2) Be performed by a physician, physician assistant, registered nurse, or licensed practical nurse licensed to practice in New Hampshire; and(3) Include administering intramuscular medication required for the treatment of a recipient's mental illness.(b) The service outlined in (a) above shall not include administration of oral medication, or medical analysis and review performed pursuant to a medication check. Administration of medication by injection and medication check may be billed, using the respective billing codes, as part of the same visit.(c) Nursing assessment and evaluation for the purpose of reviewing medication compliance, education and symptomatology shall be a covered service when provided by a registered nurse or licensed practical nurse. There shall be no more than one procedure billed per recipient per day.(d) Brief office visit shall be a covered service when conducted for the sole purpose of monitoring or changing drug prescriptions used in the treatment of mental, psychoneurotic or personality disorders by physicians, physician assistants or APRNs within the purview of their respective professions. This service shall be billed in accordance with current procedural terminology.(e) Pharmacological management, including prescription, use, and review of medication with no more than minimal medical psychotherapy conducted by physicians, physician assistants, or APRNs within the purview of their respective professions shall be a covered service.(f) Brief office visits, nursing assessment and evaluation, or pharmacologic management shall not be billed for recipients on days during which the recipient is in attendance at a partial hospitalization program. A nurse assessment and evaluation shall not be billable on the same day as a medication check.(g) Comprehensive medication service for clozapine or clozaril management shall be a covered service provided by a physician, physician assistant, APRN, registered nurse, or licensed practical nurse within the purview of their respective profession to prescribe, monitor the effects of, review, or adjust prescribed clozapine or clozaril. Treatment may be provided up to a maximum of once per day, when a documented drop in the individual's white blood cell count (WBC) occurs.(h) Comprehensive medication service for clozapine or clozaril management shall include the following: (1) Ensuring that the required blood sample is drawn;(2) Ensuring that the WBC is within established limits;(4) Sending the results of the WBC to the prescribed clozapine or clozaril monitoring system;(5) Writing the prescription for clozapine or clozaril as appropriate;(6) Ensuring that the individual is provided with a supply of clozapine or clozaril as appropriate; and(7) Signature by a physician, physician assistant, or APRN.(i) Medication services described in (c) through (f) above shall be limited to one service per day and shall not be billed on the same day as any other service described in (c) through (f) above.N.H. Admin. Code § He-M 426.07
(See Revision Note at part heading for He-M 426) #5433, eff 7-2-92; amd by #5971, eff 2-1-95; ss by #7088, eff 8-31-99; ss by #8867, eff 4-13-07; ss by #9285, eff 9-30-08
Amended by Volume XXXVI Number 41, Filed October 13, 2016, Proposed by #11182, Effective 9/29/2016, Expires 3/28/2017.Amended by Volume XXXVII Number 15, Filed April 13, 2017, Proposed by #12154, Effective 3/28/2017, Expires 3/28/2027.