| DMC State Plan | DMC-ODS | MH | Procedure Name Displayed in EHR | Procedure Definition (Developed by CalMHSA) |
|---|---|---|---|---|
| Y | Y | N | SUD Screening | Screening to determine the appropriate services for an individual seeking treatment. |
| Y | Y | N | Alcohol and/or drug screening | Used to document administration/review of alcohol and/or drug screening. |
| N | Y | N | Contingency Management | This procedure must be used to submit claims for Contingency Management Services. 15 minutes |
| Y | Y | N | SUD Crisis Intervention | SUD Crisis Intervention Services consist of contacts with a beneficiary in crisis. A crisis means an actual relapse or an unforeseen event or circumstance, which presents to the beneficiary an imminent threat of relapse.�These services should focus on alleviating the crisis problem, be limited to the stabilization of the beneficiary�s immediate situation and be provided in the least intensive level of care that is medically necessary to treat their condition. |
| Y | Y | N | Group Counseling | Group counseling related to alcohol and/or drug services. 15 minutes |
| N | Y | N | AOD Treatment | This code falls under "Recovery Services". Used to document alcohol and/or other drug treatment program services. Per hour |
| Y | Y | N | ASAM or other structured SUD Assessment | Documents determination of ASAM criteria and each code is for a different amount of time: G2011: 5-14 minutes G0396: 15-30 minutes G0397: 30+ minutes Can also be used for other structured SUD assessments. |
| Y | Y | N | Family/Couple Counseling | Alcohol and/or substance abuse services provided with a family/couple. |
| Y | Y | N | Discharge Planning | Utilized when developing discharge summaries and/or discharge plans and reviewing these documents with the beneficiary. |
| Y | Y | N | Individual Counseling | Individual Counseling consists of contacts with a beneficiary. Individual counseling can include contact with family members or other collaterals if the purpose of the collateral�s participation is to focus on the treatment needs of the beneficiary by supporting the achievement of the beneficiary's treatment goals. 15 minutes |
| Y | Y | Y | Care Coordination Outside System of Care | For SMHS: This service is designated by HCPCS code H2021 and refers to coordination of care between providers in the Mental Health System and providers who are outside the Mental Health system. H2021 can only be used to show that a delivery-system coordination of care has occurred. For other kinds of coordination, other service codes must be used. Per 15 minutes. For DMC & DMC-ODS: This service is designated by HCPCS code H2021 and refersto coordination of care between providers in the Drug Medi-Cal System and providers who are outside the Drug medi-Cal System. H2021 can only be used to show that a delivery-system coordination of care has occurred. For other kinds of coordination, other service codes must be used. Per 15 minutes. |
| Y | Y | N | Comprehensive Community Supports | Services related to helping patients access needed medical, social, educational, and other health-related services. Per 15 minutes. For DMC-ODS this is a "Recovery Service" and for DMC this is a "Treatment Planning" service. |
| N | Y | N | Environmental intervention for medical mgmt purposes on a psych patient's b | Working with agencies, employers, or institutions to address a patient's physical environment as a means to address psychiatric needs/care. |
| N | Y | N | Prenatal Risk Assessment | Administration of risk assessment related to prenatal care. |
| Y | Y | N | Psychoeducation | Includes providing information regarding mental illness and substance abuse and teaches problem-solving, communication, and coping skills to support recovery and resilience. Per 15 minutes |
| N | Y | Y | Psychosocial Rehab - Individual | For SMHS, "Rehabilitation� means a service activity which includes, but is not limited to assistance in improving, maintaining, or restoring a beneficiary�s or group of beneficiaries� functional skills, daily living skills, social and leisure skills, grooming and personal hygiene skills, meal preparation skills, and support resources; and/or medication education. Per 15 minutes. For DMC-ODS, rehabilitation falls under "Recovery Services" and can document education related to mental health, substance abuse, independent living, social, coping and interpersonal skills, relapse prevention, etc. Per 15 minutes. |
| Y | Y | N | Client Education | The DHCS billing manual states that this should be utilized to submit claims for Patient Education Services. Per 15 minutes |
| N | Y | Y | TCM/ICC | Services that assist a beneficiary to access needed medical, educational, social, prevocational, vocational, rehabilitative, or other community services. The service activities may include, but are not limited to, communication, coordination, and referral; monitoring service delivery to ensure beneficiary access to service and the service delivery system; monitoring of the beneficiary�s progress; placement services; and plan development. Each 15 minutes. This is also the code utilized to capture Intensive Care Coordination (ICC) services. Targeted Case Management is a type of Care Coordination code that can be used by DMC-ODS providers. |
| Y | Y | N | Methadone - Day Service | Methadone administration and/or service (provision of the drug by a licensed program) |
| Y | Y | Y | Care Coordination Outside System of Care Group | For SMHS: This service is designated by HCPCS code H2021 and refers to coordination of care between providers in the Mental Health System and providers who are outside the Mental Health system. H2021 can only be used to show that a delivery-system coordination of care has occurred. For other kinds of coordination, other service codes must be used. Per 15 minutes. For DMC & DMC-ODS: This service is designated by HCPCS code H2021 and refers to coordination of care between providers in the Drug Medi-Cal System and providers who are outside the Drug medi-Cal System. H2021 can only be used to show that a delivery-system coordination of care has occurred. For other kinds of coordination, other service codes must be used. Per 15 minutes. |
| Y | Y | N | Residential Treatment -Substance Use | H0012: Alcohol and/or drug services: (residential addiction program outpatient). Subacute detoxification (DMC-ODS ONLY) H0019: Behavioral Health; Long Term Residential (non-medical, non-acute care in a residential treatment program where stay is typically longer than 30 days) without room and board (Both DMC and DMC-ODS) |
| - | - | - | General Outreach | An outreach activity not tied to a specific client. For example: running a mental health/behavioral health booth at a local fair. This would be used in conjunction with an Organizational Client. |
| - | - | - | Targeted Outreach | An outreach activity tied to a specific client. For example: law enforcement has a list of high-risk individuals that county MH is reaching out to in order to get them into treatment. |
| - | - | - | Quality Improvement Activities | Any type of Quality Improvement and/or administrative time, such as chart review, attending a QI-related meetings, etc. |
| - | - | - | Consults to External Providers (Non-billable) | Documents consults with physical health care providers, primary care providers or other relevant healthcare providers. |
| - | - | - | Transportation | Documents services that are strictly transportation-related. If a billable service was provided during the transport, the appropriate billable procedure code should be selected. |
| - | - | - | Client Non Billable Srvc Must Document | Any other non-billable service that must be documented and is not better accounted for by other available non-billable procedure codes. |
| - | - | - | Prev Prob Identification-AOD | Used to track SABG funded primary prevention activities using this strategy |
| - | - | - | Prev Education-AOD | Used to track SABG funded primary prevention activities using this strategy |
| - | - | - | Prev Community Based-AOD | Used to track SABG funded primary prevention activities using this strategy |
| - | - | - | Prev Info Dissemination-AOD | Used to track SABG funded primary prevention activities using this strategy |
| - | - | - | Prev Environ Strategy-AOD | Used to track SABG funded primary prevention activities using this strategy |
| - | - | - | Prev-Alternatives-AOD | Used to track SABG funded primary prevention activities using this strategy |
| - | - | - | Quality Assurance-AOD | Used to track SABG funded quality assurance activities |
| Y | Y | Y | Transportation Mileage | Mobile Crisis Add On - Used when transporting a client to a treatment facility; measures mileage |
| Y | Y | Y | Transportation, Staff Time | Mobile Crisis Add On - Used when transporting a client to a treatment facility OR when accompanying a client being transported by law enforcement, ambulance, or other valid transportation method; measures time spent during the transportation |
| - | - | - | Inpatient Psychiatric Procedure | Used to document a non-billable psychiatric procedure done in an inpatient unit |
| - | - | - | Shift Summary | Used to document a Shift Summary note when a client is in an inpatient or residential facility. This is a non-billable service, as the services will be bundled for these facilities. |
| - | - | - | Non-Billable Bed Procedure | Used to track non-billable bed days or bed procedures not otherwise captured elsewhere for facilities that do bed management (IP/CSU/Res) |
| - | - | - | Brief Contact Note | Used to document a brief, non-treatment services contact with the client, such as confirming an appointment. |
| N | Y | N | Ambulatory Withdrawal Management | Alcohol and/or drug services; ambulatory detoxification. |
| - | - | - | Residential Daily Note | Used to document your daily summary note for residential services. |
| - | - | - | Non-Billable Attempted Contact | To be utilized when documenting attempts to contact a client but have been unsuccessful in reaching them. |
| N | Y | N | Residential Withdrawal Management | SUD Residential Withdrawal Management day service |
| N | Y | N | Partial Hospitalization-Substance Use | S0201: Partial Hospitalization Services; less than 24 hours, per diem (DMC-ODS ONLY). |
| - | - | - | Attestation Note | Used for attendings if they want to add any additional context to the original note by residents/NP. We recommend attaching this note to the original note written by the resident/NP. |
| - | - | - | Legal Report Writing Note | Used when writing reports or documentation for court or legal procedings, including LPS Conservatorship assessments, JV220s, or other court-related documents. This is also used for other reports, such as making CPS or APS reports, entering state reporting items, or writing grant-required reports for a specific client. |
| - | - | - | CARE Act - Notice Activity | Used when a staff member is drafting noticies for CARE Act processes, including all hearing and appearance notices, CARE Agreement notices, etc. |
| - | - | - | CARE Act - Outreach and Engagement | Used for documenting all outreach and engagement activities required to engage the respondent. Also used when developing a CARE Agreement with the respondent. |
| - | - | - | CARE Act - Court Report Activity | Used when a staff member is drafting needed reports for CARE Act processes, including CARE Agreement, Clinical Evaluation, CARE Plan, etc. |
| - | - | - | CARE Act - Hearing Time | Used to document activities that occur and time spent during CARE Act hearings. |
| Y | Y | Y | Mobile Crisis Encounter | Used when the Mobile Crisis Team is dispatched to a site to address a person's crisis. This is a bundled service and will bill a flat rate regardless of time indicated. It is recommended that staff continue to track the time spent on each encounter. |
| Y | Y | Y | Mobile Crisis Dispatch Screening | Used to document the screening provided to determine if the Mobile Crisis Team is dispatched to a location or not. |
| Y | Y | Y | Mobile Crisis Follow-Up | Used to document required follow-ups for Mobile Crisis Encounter. |
| - | - | - | CARE Act - Data Reporting | Used for data reporting activities related to the CARE Act |
| - | - | - | Room and Board | Used to track Room and Board services. These aren't billable to Medi-Cal but may need to be tracked for other reimbursement or tracking purposes. |
| - | - | - | Bed Hold Day | Non-billable code to use when you're holding a bed for a specific client, but they're currently not occupying that bed. |
Updated 4/9/24