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Bulletin ID: No. 9 - Cease Providing Reimbursement for Local Code DMH 19

Wednesday, August 30, 2006

Effective immediately, for dates of service on or after October 1, 2006, DMH will cease providing reimbursement for local code DMH 19, and will eliminate that code. 

As described in Release 1.3 of the District of Columbia Department of Mental Health Companion Guide ANSI 837 Professional Claims dated April 23, 2004 (the “Companion Guide”), DMH 19 is the code for “IRP Documentation,” see p. 48, and is defined as the “[c]ode to use for billing up to 60-units  (15 hours)  annual allowance of IRP/IPC documentation,” see p. 54.  DMH 19 has been reimbursed at $20.10 per 15 minute unit, the same rate as individual community support.

DMH plans to reallocate the financial resources that have been used to pay DMH 19 to provide additional funding for providers to deliver MHRS services to uninsured consumers who do not qualify for Medicaid, and to provide non-Medicaid covered MHRS services to Medicaid beneficiaries. 

If you have questions about the elimination of DMH 19, please contact your provider relations representative.