Mental Health and Rehabilitation Clinics (MHRC)

Mental Health and Rehabilitation Clinics (MHRC)

Revisions to Rehabilitative Behavioral Health Services Policy and Procedures

 

The South Carolina Department of Health and Human Services (SCDHHS) is revising the Rehabilitative Behavioral Health Services (RBHS) Policy Manual. Changes will be effective on or after Jan. 1, 2016. The intent of this bulletin is to provide notice of general revisions; it is not intended to reflect all revisions in the manual. These changes apply to fee for service RBHS only.

Medical Necessity

Prior Authorization Schedule

The South Carolina Department of Health and Human Services (SCDHHS) will implement the following one-time change to the Rehabilitative Behavioral Health Services (RBHS) prior authorization (PA) schedule for beneficiaries age 0-21. This change to the submission schedule for PAs will allow the Quality Improvement Organization (QIO) to operate more efficiently and generate a more timely response to PA requests.

Revisions to Rehabilitative Behavioral Health Services Policy and Procedures - Administrative Changes

Effective Nov. 1, 2015, the South Carolina Department of Health and Human Services (SCDHHS) will implement modifications to the Rehabilitative Behavioral Health Services (RBHS) Policy Manual. These manual revisions will strengthen fee-for-service Medicaid requirements related to several areas of the provider manual including:

  1. provider accreditation,
  2. provider and staff credentials and
  3. business requirements.

 

Community Support Services Credentialing; Rehabilitative Behavioral Health Services Policy Reminder

The South Carolina Department of Health and Human Services (SCDHHS) released a Medicaid Bulletin

April 13, 2015, outlining new Rehabilitative Behavioral Health Services (RBHS) policy changes effective July 1, 2015, for private RBHS/Therapeutic Foster Care (TFC) Medicaid providers rendering Community Support Services. The policy allows a staff person with less than a bachelor's degree employed by a RBHS/TFC organization to provide Community Support Services (CCS) to children and adolescents who are referred to TFCs by state agencies.

Rehabilitative Behavioral Health Services Changes Updates

The South Carolina Department of Health and Human Services (SCDHHS) released a Medicaid Bulletin April 13, 2015, outlining new Rehabilitative Behavioral Health Services (RBHS) policy changes effective May 1, 2015. There are two updates to this bulletin.

Rehabilitative Behavioral Health Services Changes

The South Carolina Department of Health and Human Services (SCDHHS) will implement the following changes to the Rehabilitative Behavioral Health Services (RBHS) policy. These changes apply to fee for service RBHS only and are effective May 1, 2015, unless otherwise specified in this bulletin.

  1. Prior Authorizations

 

Rehabilitative Behavioral Health Services Changes

 

Effective March 1, 2015, the South Carolina Department of Health and Human Services (SCDHHS) will implement the following changes to the Rehabilitative Behavioral Health Services (RBHS) policy. These changes apply to fee for service RBHS only.

  1. Medical Necessity and Prior Authorizations

Behavioral Health Providers

Effective with dates of service on or after February 1, 2015, the South Carolina Department of Health and Human Services (SCDHHS) will reimburse for conducting and scoring the Child and Adolescent Level of Care Utilization System (CALOCUS) using procedure code H2000 with the appropriate billing modifier.  This code is billed per encounter (one per date of service) per Healthy Connections member requiring the service with a maximum of two encounters per month per member. The completed assessment, scoring sheet and supporting documentation must be maintained in the member’s clinical record.

Intensive Family Services (Procedure Code H0046)

The South Carolina Department of Health and Human Services (SCDHHS) issued a bulletin Nov. 17, 2014, announcing the addition of Intensive Family Services (IFS) to the Rehabilitative Behavioral Health Services (RBHS) manual and the Licensed Independent Practitioners (LIP) Rehabilitative Services manual with an effective date of January 1, 2015. This effective date is postponed. SCDHHS will issue a Medicaid bulletin 30 days in advance of the new effective start date.

If you have any questions, please contact the Provider Service Center at (888) 289-0709.

Intensive Family Services (Procedure code H0046)

IFS is provided both within the beneficiary’s home and in community settings. IFS targets the family unit to promote positive treatment outcomes. 

IFS is goal-directed and supports solution-focused interventions intended to achieve identified goals or objectives as set forth in the child or youth’s plan of care. The purpose of this service is to improve youth and family functioning and prevent out-of-home placement, or to reunify children into their homes when out-of-home placement has occurred. IFS is available to eligible beneficiaries ages 0-21.

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