Section He-M 426.08 - Psychotherapeutic Services(a) Individual psychotherapy shall: (1) Be a covered CMHP service;(2) Include therapy, crisis intervention, or assessment and monitoring necessary to determine the course and progress of therapy or to stabilize an individual experiencing an acute psychiatric episode; and(3) Be verbal, with the therapist in direct, personal, involvement with the recipient to the exclusion of other recipients, individuals, and duties.(b) Individual psychotherapy shall be billed in accordance with current procedural terminology. Individual therapy with medication management shall be billed as one procedure when delivered during the same visit.(c) Group psychotherapy per person shall: (1) Be a covered CMHP service; and(2) Be therapy, or assessment and monitoring necessary to determine the course and progress of therapy, that is performed in a direct, personal, involvement with the recipient in a setting with other recipients or individuals.(d) Group psychotherapy shall be billed in accordance with current procedural terminology.(e) Group psychotherapy shall meet the following criteria:(1) A minimum of 2 unrelated recipients and a maximum of 10 recipients shall be in attendance to constitute a group;(2) Sessions shall be scheduled often enough to provide effective treatment consistent with the ISP;(3) The group focus shall be face-to-face dialogue of a verbal rather than performance nature; and(4) Individual progress notes for each session shall be recorded in each recipient's record with specific attention directed toward goal achievement as stated in the recipient's ISP.(f) Family therapy shall be: (1) A covered service; and(2) Psychotherapy with: a. The primary identified recipient and that recipient's natural or surrogate family member(s); orb. The natural or surrogate family member(s) without the recipient present.(g) Billing for family therapy shall be as follows: (1) Only one family member's medicaid identification number shall be billed regardless of the eligibility of other members or their inclusion in the problem;(2) If a child who has been determined eligible for services pursuant to He-M 401 is the primary reason for the family to be receiving therapy, then that child's medicaid identification number shall be used when billing for services;(3) If the primary recipient is not present but continues to be the focus of the therapy, that recipient's medicaid identification number shall be used when billing for services and the reason why the recipient was not present shall be documented; and(4) This procedure shall be billed in accordance with current procedural terminology.(h) For the purpose of providing psychotherapy without supervision, clinical staff of CMHPs or providers shall meet the applicable following minimum qualifications: (1) Psychiatrists shall meet the requirements of RSA 135-C:2, XIII;(2) Psychologists shall be licensed in accordance with RSA 329-B;(3) Pastoral psychotherapists shall be licensed in accordance with RSA 330-A:17;(4) Marriage and family therapists shall be licensed in accordance with RSA 330-A:21;(5) Clinical mental health counselors shall be licensed in accordance with RSA 330-A:19;(6) Clinical social workers shall be licensed in accordance with RSA 330-A:18; and(7) Nurses shall be registered as required by RSA 326-B:6 and have a master's degree in psychiatric nursing or be licensed as an advanced registered nurse practitioner (APRN) with a psychiatric mental health specialty in accordance with RSA 326-B:11.(i) Except as provided pursuant to (k) and (m) below, anyone providing psychotherapy services who does not meet the established standards as indicated in (h) above shall: (1) Have completed at least one year of work in the field of psychiatric or mental health services under the supervision of a psychiatrist, doctoral level psychologist or a licensed mental health professional or person authorized pursuant to RSA 329-B:28, I(e); and(2) Have at least a master's degree in marriage and family therapy, psychology, social work, rehabilitation counseling, or education/counseling from a college or university accredited by an accrediting agency recognized by the U.S. Department of Education; or(3) Be a registered nurse with a certificate in mental health nursing from the American Nurses's Association.(j) Persons who qualify to provide psychotherapy pursuant to (i) above shall have ongoing supervision of at least 2 hours per month. There shall be direct individual or group supervision of at least one hour per month by a licensed practitioner of the healing arts. The second hour may be peer review or case review, such as client centered conferences. Direct supervision shall occur when the supervisor meets with the clinician to review his or her clinical practice in order to evaluate his or her performance.(k) Persons who are enrolled in formal internships in a professional field of study of mental health services and provide psychotherapy services shall: (1) Be enrolled in at least a master's degree program in psychology, social work, rehabilitation counseling, education/counseling, or nursing at a college or university accredited by an accrediting agency recognized by the U.S. Department of Education; or(2) Be enrolled in a doctoral or post-doctoral program at a college or university accredited in psychology by an accrediting agency recognized by the U.S. Department of Education.(l) Persons providing psychotherapy pursuant to (k) above shall receive direct supervision of at least one hour per week from a licensed practitioner of the healing arts, appropriate to the intern's field of study. The medicaid program shall reimburse CMHPs and community mental health providers only when supervision occurs and is documented. Direct supervision shall occur when the supervisor meets with the intern to review his or her clinical practice in order to evaluate his or her performance. The supervisor shall write and sign a weekly note in the intern's supervisory record stating his or her observations and recommendations relative to the intern's performance, and a monthly note summarizing his or her evaluation.(m) Pursuant to RSA 135-C:3, persons providing medicaid reimbursed psychotherapy services in approved CMHPs prior to July 1, 1987, the initial effective date of He-M 426, shall be considered to have met the standards for other providers of psychotherapy set forth in (i) above and shall be supervised in accordance with the applicable requirements in (j) above.N.H. Admin. Code § He-M 426.08
(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.