MHS-Individual or Group Therapy (Procedure Codes pages 3,4 and 8; Org Manual page 2-4)

1. Coding, Claiming, and Documentation QuestionsAssociation of CommunityHuman Service Agencies November 20, 2008Norma A. Fritsche, MSN/MPA, MHC District ChiefLos Angeles County, Department of Mental HealthProgram Support Bureau, Quality Assurance

2. MHS-Individual or Group Therapy(Procedure Codes pages 3,4 and 8; Org Manual page 2-4) • Definition: Insight oriented, behavior modifying, supportive psychotherapy, interactive play therapy and/or therapy using non-verbal techniques. • Procedure Codes: 16 different codes, see Procedure Codes Guide • Important to Remember: • Individual therapy involves only one client • Collaterals or agency staff may be present • Group therapy involves two or more clients • Can only be used by: • MD/OD • RN/NP • Licensed/waivered Psychologists • Licensed/registered Social Worker & MFT

3. MHS-Individual or Group Rehab(Procedure Codes pages 5 and 8; Org Manual page 2-4) • Definition: Assistance in improving, maintaining, or restoring client’s functional, daily living, social/leisure, grooming/personal hygiene, meal prep skills, support resources • Procedure Code: H2015 • Important to Remember: • Individual Rehab involves only one client but potentially many collaterals or agency staff • Group Rehab involves two or more clients • License is not required • Assistance does NOT mean doing something for someone, but helping a person with an impairment through habilitative or re-habilitative activities learn how to perform a task s/he had previously been unable to perform due to his/her mental disability

4. TCM-Targeted Case Management(Procedure Codes page 10; Org Manual page 2-14) • Definition: Services needed to access medical, educational, social, prevocational, vocational, rehabilitative, or other community services. These services, whether face-to-face, by phone, or through correspondence, provide for the continuity of care within the mental health system and related social service systems. Services include linkage and consultation, placement, and plan development. • Procedure Code: T1017 • Important to Remember: • TCM is the linkage and brokerage to a service and not the provision of the service itself • To obtain Medi-Cal reimbursement for TCM, the linkage and brokerage activities must be related to addressing the client’s mental health needs

5. Combined Services in a Single Contact such as a CFT • Distinct Services should not be combined • If distinct services occur in one contact, each distinct service should be documented and claimed separately • Licensed clinician provides therapy to the client and unlicensed facilitator and CFS provide family and client interventions • Document and claim Therapy for the clinician • Document and claim Individual Rehab for the facilitator and CFS • During a Team Conference where interventions are directed at agency staff but client is present, the CFS has to prompt an anxious client • Document and claim for team conference for staff participation time • Document and claim a separate note for the time the CFS prompted client using Individual Rehab • A CFT can look like a lot of different services during a single contact • Example 1: Facilitator checks in with client, family members, and staff during a CFT, checking in about progress and status • Plan development as stand alone service • Example 2: Facilitator directs discussion with staff, client, and family members re: progress, strategies and actions to take (i.e. baseball vs. ballet) • Individual Rehab with plan development