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Bulletin ID: No. 76 - Services Provided to Youth Consumers in School

Thursday, December 8, 2011

Services provided to youth consumers in school:
This bulletin is to clarify when it is appropriate to provide Mental Health Rehabilitation Services (MHRS) to youth consumers in school.  MHRS services can be provided in schools to youth under very limited circumstances.

1. Team meetings involving school personnel

a. Collaboration / team meetings may be claimed as a community support service by the certified agency convening the meeting.  Any other MHRS providers involved in the meeting may claim their time under the DMH LOCAL code DMH20 for team meetings. (See DMH Billing Manual for information on annual limits for DMH20.)

b. If the meeting is convened by the school and MHRS provider is participating (including IEP meetings), the service cannot be billed to Medicaid.  The MHRS provider should bill the service as DMH LOCAL code DMH20 for team meeting.

2. Services prescribed in the Individualized Education Program (IEP) CANNOT be billed under MHRS. 

a. Services prescribed in the IEP are the responsibility of DCPS to provide.

3. MHRS may be provided in schools, but not in the classroom itself. 

a. Services are to be provided outside of the classroom.

b. Working with consumer in class to help him/her stay on task to complete school work is NOT an allowable MHRS activity; it is an educational activity and if needed should be part of the IEP.

4. Observing a consumer in class is not a billable activity, unless the observation is to assess consumer’s behaviors in the classroom as a part of the Diagnostic Assessment.
5. Assisting consumer with academic skills, even when outside of the classroom is NOT an allowable activity under MHRS.  It is an educational service, which is strictly prohibited as MHRS.  Prohibited educational activities include:

a. Tutoring on school subjects, assisting with school or homework
b. Teaching test-taking skills

Questions:  contact Venida Y. Hamilton, Director, Provider Relations 202-671-3155