(1) Mental health center services, covered by the Medicaid program, include the following:

(a) adult half-day day treatment services;

(b) child and adolescent day treatment services;

(c) community based psychiatric rehabilitation and support;

(d) program of assertive community treatment;

(e) respite care services;

(f) in-training practitioner services; and

(g) the therapeutic component of:

(i) crisis intervention services;

(ii) foster care for mentally ill adults; and

(iii) mental health adult group home services.

(2) The therapeutic component of crisis intervention services includes all crisis intervention services provided by the mental health center and, except as provided in (4) (a) , its staff, but does not include room and board.

(3) A mental health center may provide case management services for youth with serious emotional disturbance and adults with severe disabling mental illness if enrolled as a provider of such services and in accordance with the requirement of Medicaid rules applicable to those service categories. Case management services will be reimbursed only to the extent allowable and according to the Medicaid rules applicable to the particular category of service.

(4) Mental health center services do not include practitioner services, except as specifically provided by and in accordance with the requirements of these rules. Except as provided by these rules, practitioner services may be covered and reimbursed by Medicaid only if the practitioner is enrolled as a provider and according to the Medicaid rules and requirements applicable to the practitioner's category of service.

(a) Mental health center services may include practitioner services provided according to mental health center license requirements as part of mental health center services. To the extent otherwise permitted by applicable Medicaid rules, such practitioner services may be billed by the mental health center either as mental health center services or by the practitioner under the applicable Medicaid category of service, but may not be billed as both mental health center services and practitioner services.

(b) Mental health center services, covered by the Medicaid program, include the medical director component of a physician's services to the mental health center, but do not include the professional component of physician services covered in ARM 37.86.101, 37.86.104 and 37.86.105. The professional component of physician services may be billed according to the provisions of (4) (a) or ARM 37.86.101, 37.86.104, and 37.86.105.

(5) To the extent provided as part of mental health center services in accordance with (4) (a) :

(a) family counseling is covered as a mental health center service only if medically necessary for the treatment of the Medicaid eligible family member who is involved in the family therapy; and

(b) individual therapy includes diagnostic interviews where testing instruments are not used.

(6) Practitioner services provided in a hospital on an inpatient basis that are covered by Medicaid as part of the diagnosis related group (DRG) payment under ARM 37.86.2907 are not reimbursable as mental health center services. These non-covered services include:

(a) practitioner services provided by practitioners who are staff of a mental health center which has a contract with a hospital involving consideration;

(b) services provided for purposes of discharge planning as required by 42 CFR Part 482.43; and

(c) services including but not limited to group therapy, that are required as a part of hospital licensure or certification.