Policy Revisions to the Local Education Agency (LEA) Services Manual for Rehabilitative Behavioral Health Services (RBHS)

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The South Carolina Department of Health and Human Services (SCDHHS), Division of Behavioral Health, will revise the Local Education Agency (LEA) manual for the Rehabilitative Behavioral Health Services (RBHS) policy section to discontinue use of the FORM 255 as of November 1, 2014. The Department of Education will continue to ensure the LEAs track the referral process for Psychological Testing and Evaluation. In accordance with the definition of Rehabilitative Services found at 42 CFR §440.130, (d), these services include any medical or remedial services recommended by a physician or other licensed practitioner of the healing arts, within the scope of his practice under State law, for maximum reduction of physical or mental disability and restoration of a beneficiary to his best possible functional level. The referral must be documented on a clinical service note and maintained in the beneficiary's clinical record.

The Psychological Testing and Evaluation policy, as it relates to LEAs, will be relocated in the RBHS policy section and the procedure code policy section will be updated accordingly. This change does not pertain to the License Independent Practitioners manual.

Healthy Connections Medicaid members may continue to receive RBHS when there is a confirmed psychiatric diagnosis from the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD) (excluding irreversible dementias, intellectual disabilities or related disabilities, and developmental disorders unless they co-occur with a serious behavioral health diagnosis that meets the current edition DSM or ICD criteria).

For a complete copy of the policy changes, please refer to the most current version of the LEA services manual located on the SCDHHS website at www.scdhhs.gov .

If you should have any questions regarding program policy, please contact the Division of Behavioral Health at (803) 898-2565. Please refer any questions or concerns regarding claims to the SCDHHS Provider Service Center at 1-(888)-289-0709. Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.

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