Brief_Episode_Stabilization_-_BES.doc

Travel with a participant when the brief episode

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Travel with a participant when the Brief Episode Stabilization provider is also engaged in a qualifying waiver service activity. Limitations Coverage of Brief Episode Stabilization services shall be subject to the following limitations: 1. Brief Episode Stabilization services are subject to service volume (number of ¼ hours service units per day and/or week) and duration (number of months or specified service end date) limits established in the waiver Recovery Plan approved by DMHAS and DSS. 2. Brief Episode Stabilization services shall be based on the waiver Recovery Plan and shall be performed by or under the supervision of a licensed clinician employed by or under contract to the provider; 3. A claim for reimbursement may be submitted for the qualifying waiver services activities of only one staff member providing Brief Episode Stabilization services to a participant during a specific time period (i.e., billable unit of time); 4. Recovery Assistant services cannot be billed concurrently with Brief Episode Stabilization. 5. The department shall not pay for: a. Time spent by the provider solely for the purpose of transporting participants; b. Programs, services or components of services that are of an unproven, experimental, cosmetic or research nature; c. Programs, services or components of services that do not relate to the participant’s diagnosis, symptoms, functional limitations or medical history; d. Programs, services or components of services that are not included in the fee established by the department; e. Services or components of services provided solely for social, recreational, educational or vocational purposes; and f. Costs associated with room and board for participants. Non-billable Activities The following activities are not billable, but have been factored into payment rates: 1. Communication and coordination with the DMHAS Support Coordinator, and with other service providers to relay information germane to the participant’s needs and continued recovery; 2. Telephone contact with the participant; 3. Telephone contact with the department or its designated agent for the purpose of requesting or reviewing authorization; 4. Completion of progress notes or billing documentation; 5. Individual or group supervision, routine case reviews and rounds, ad hoc consultation with supervisors and
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  • Summer '14
  • JohnWeekes
  • mental health, supervisor, service provider

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