AGENCY FOR HEALTH CARE ADMINISTRATION
RULE NO.:RULE TITLE:
59G-4.050Community Behavioral Health Services
NOTICE OF CHANGE
Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 39, No. 2013, October 17, 2013 issue of the Florida Administrative Register.
59G-4.050 Community Behavioral Health Services.
(3) The following form is included in the Florida Medicaid Community Behavioral Health Coverage and Limitations Handbook and is incorporated by reference: Temporary Service Authorization, AHCA Form 5000-3510, Revised December 2012. This form is available by photocopying it from the Florida Medicaid Community Behavioral Health Coverage and Limitations Handbook.
The following changes have been made to the Florida Medicaid Community Behavioral Health Services Coverage and Limitations Handbook.
Page 1-2 New definition is added:
Emotional Disturbance
A person under the age of 21 years who is diagnosed with a mental, emotional, or behavioral disorder of sufficient duration to meet one of the diagnostic categories specified in the most recent edition of the Diagnostic and Statistical Manual of the American Psychiatric Association, but who does not exhibit behaviors that substantially interfere with or limit the role or ability to function in the family, school, or community. The emotional disturbance must not be considered to be a temporary response to a stressful situation.
Page 1-2 Institution for Mental Disease
This section will now read:
A hospital or other institution of more than 16 beds that is primarily engaged in providing diagnosis, treatment, or care to persons with behavioral diseases in accordance with 42 CFR 435.1010.
Page 1-2 New definition is added:
Serious Emotional Disturbance
A person under the age of 21 years who is all of the following:
- Diagnosed as having a mental, emotional, or behavioral disorder that meets one of the diagnostic categories specified in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association.
- Exhibits behaviors that substantially interfere with or limit the role or ability to function in the family, school, or community, which behaviors are not considered to be a temporary response to a stressful situation.
Page 1-7 Medical Assistant
This section will now read:
A medical assistant must be registered or certified in accordance with Chapter 458, F.S.
Page 1-7 Psychiatric Clinical Nurse Specialist (CNS)
The last paragraph will now read:
A registered nurse currently enrolled as an LPHA must be licensed as a CNS with a subspecialty of child/adolescent psychiatric and mental health or psychiatric and mental health by January 1, 2016.
Page 1-9 Provider Qualifications
The first bullet will now read:
- Employ or have under contract a Medicaid-enrolled psychiatrist or a physician, who is linked with the Medicaid group provider.
The last bullet will now read:
- Hold a regular (i.e., not probationary or interim) substance abuse license in accordance with Chapter 65D-30, F.A.C., for at least one of the following components, if substance abuse services are provided:
– Prevention
– Intervention
– Outpatient
Page 2-4 Recipient Clinical Record, continued
The first pragraph is deleted.
The note has the word more deleted.
Page 2-4 General Service Documentation Requirements
The last paragraph is deleted.
A note is added after the bulleted list that reads:
Note: For information about electronic signatures, see the Florida Medicaid Provider General Handbook.
Page 2-5 Telemedicine
The following sentence is added at the end of the first paragraph:
Services that can be provided through telemedicine are listed in the Procedure Codes and Fee Schedule, found in the appendices.
Page 2-6 Psychiatric Evaluation
The third paragraph will now read:
A psychiatric evaluation must be conducted at the onset of illness. It can be utilized again if an extended hiatus occurs, a marked change in mental status occurs, or admission or readmission to an inpatient setting for a psychiatric illness is being considered or occurs.
The last paragraph is deleted.
Page 2-7 Brief Behavioral Health Status Examination
The second paragraph will now read:
A brief behavioral health status examination is not required when a psychiatric evaluation, bio-psychosocial assessment, or in-depth assessment has been completed by a physician, psychiatrist, LPHA, or a master’s level CAP within six months prior to the development of recipient’s treatment plan.
The last paragraph is deleted.
Page 2-13 Introduction
The third paragraph will now read:
A treatment plan should directly address additional diagnoses that are consistent with assessment and that are in the range of the provider’s expertise. The provider must document efforts to coordinate services for diagnoses outside their expertise that, if treated, would assist meeting the recipient’s goals.
Page 2-17 Who Must Provide
PA is added as a bulleted item.
Page 2-17 Brief Individual Medical Psychotherapy
The last paragraph is deleted.
Page 2-18 Who Must Provide (at the top of the page)
PA is added as a bulleted item.
Page 2-19 Behavioral Health-Related Medical Services: Verbal Interactions
The last paragraph is deleted.
Page 2-20 Behavioral Health-Related Medical Services: Alcohol and Other Drug Screening Specimen Collection
This section will now read:
This procedure code covers specimen collection for the purposes of alcohol and other drug testing for the treatment of substance use disorders.
Page 2-21 Medication-Assisted Treatment
The F.A.C. citation in the last paragraph is changed to Rule 65D-30.014.
Page 2-23 Eligibility Criteria
The first bullet will now read:
- Be age 2 years and older.
Page 2-23 Components of Behavioral Health Day Services
The word interventions is deleted from the second and fourth paragraphs.
Page 2-24 Components of Behavioral Health Day Services, continued
This paragraph will now read:
Therapeutic care services assist the recipient in the development of the skills necessary for independent living and for symptom management. Progress toward treatment goals related to therapeutic care services should be assessed through observation.
Page 2-26 Introduction
The word therapy is deleted from the second paragraph.
The last paragraph is deleted.
Page 2-28 Clubhouse Services
The last paragraph is deleted.
Page 2-30 Eligibility Criteria
In the third and fourth bullets, the phrase “as defined in Chapter 394, F.S.” is deleted.
Document Information
- Related Rules: (1)
- 59G-4.050. Community Behavioral Health Services