SCDHHS Behavioral Health Provider Manuals Updates for Jan. 1, 2023

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The South Carolina Department of Health and Human Services (SCDHHS) is announcing updates to several behavioral health policies. The updates are described below and are effective beginning Jan. 1, 2023.

Community Mental Health Services Provider Manual

The following updates will be published in the Community Mental Health Services provider manual prior to the Jan. 1, 2023, effective date.

  • A new link will be added to the program overview section that will contain a list of suggested evidenced-based practices;
  • Staff-to-beneficiary ratios will now all be listed in the same section of the manual;
  • Discharge criteria will now be found in a new section that will be added to the manual;
  • Progress summaries must now include any barriers to progress and the reason why there was a failure to provide the recommended services and frequencies, when applicable; and, · Services that were previously referenced in the Rehabilitative Behavioral Health Services (RBHS) provider manual will be added to the Community Mental Health Services provider manual along with their parameters for medical necessity, staff qualifications and service definitions. These services include:
  • Psychological testing and evaluation (PTE), psychosocial rehabilitation  services (PRS), behavior modification (BMod), family support (FS) and peer support services (PSS).

Licensed Independent Practitioners Provider Manual

The following updates will be published in the Licensed Independent Practitioners provider manual prior to the Jan. 1, 2023, effective date.

  • CPT code 96130 will be added for PTE; and,
  • Progress summaries must now include any barriers to progress and the reason why there was a failure to provide the recommended services and frequencies, when applicable.

RBHS Provider Manual

The following updates will be published in the RBHS provider manual prior to the Jan. 1, 2023, effective date.

  • The requirement for a raised seal on employee transcripts will be removed;
  • Evaluation requirements for PSS will be removed;
  • Progress summaries must now include any barriers to progress and the reason why there was a failure to provide the recommended services and frequencies, when applicable; and,
  • Evidenced-based practices that are used during services will be required to be documented in a clinical service note.

Psychiatric Hospital Services Provider Manual

The following updates will be published in the Psychiatric Hospital Services provider manual prior to the Jan. 1, 2023, effective date.

  • Certificate of need requirements will be changed to indicate the comprehensive assessment must be conducted within 10 business days by a Licensed Practitioner of the Healing Arts (LPHA);
  • Training requirement updates will reflect the use of mental health first aid as optional and the addition of trainings to address growth and development, group dynamics, behavioral health disorders, therapeutic boundaries, grief and loss, cultural diversity and suicide awareness; and,
  • Cost history reporting will no longer be required before receiving a reimbursement rate.

Local Education Agencies Services Provider Manual

The following updates will be published in the Local Education Agencies Services provider manual prior to the Jan. 1, 2023, effective date.

  • Discharge criteria will be added;
  • Progress summaries must now include any barriers to progress and the reason why there was a failure to provide the recommended services and frequencies, when applicable; and,
  • Evidenced-based practices that are used during services will be required to be documented in a clinical service note.

Autism Spectrum Disorder Services Provider Manual

The following updates will be published in the Autism Spectrum Disorder Services provider manual prior to the Jan. 1, 2023, effective date.

  • A documentation requirement that indicates the beneficiary rights were reviewed and acknowledged will be added;
  • Next-of-kin or responsible party will be able to sign the consent form when a crisis prevents the Medicaid member or parent from signing; and,
  • Progress summaries must now include any barriers to progress and the reason why there was a failure to provide the recommended services and frequencies, when applicable.

Please direct any questions or concerns regarding these updates to the SCDHHS Office of Behavioral Health at (803) 898-1891 or behavioralhealth004@scdhhs.gov.

Thank you for your continued support of the South Carolina Healthy Connections Medicaid Program.

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