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Licensed Clinical Social Worker (LCSW) & Licensed Marriage and Family Therapist (LMFT/MFT)

Service AreaProcedure Name Displayed in EHRProcedure Definition (Developed by CalMHSA)
DMC, DMC-ODSAlcohol and/or drug screeningUsed to document administration/review of alcohol and/or drug screening.
DMC-ODSAOD TreatmentThis code falls under "Recovery Services". Used to document alcohol and/or other drug treatment program services. Per hour
DMC, DMC-ODSASAM 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

MHAssessment Contribution non-LPHAUsed to document assessment work/services completed by non-clinical staff. Assessment means a service activity designed to evaluate the current status of a beneficiary’s mental, emotional, or behavioral health. Assessment includes one or more of the following: mental status determination, analysis of the beneficiary’s clinical history, analysis of relevant biopsychosocial and cultural issues and history, diagnosis and the use of testing procedures. 15 minutes
MH, DMC, DMC-ODSAssessment LPHAPsychiatric diagnostic evaluation is an integrated biopsychosocial assessment, including history, mental status, and recommendations. Although physicians and other qualified medical staff are permitted to utilize this code, this procedure code is mainly utilized by non-physician clinical staff who are documenting services that would typically fall under the category of "Assessment". 15 minutes
MH, DMC, DMC-ODSCare 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.

MHCare Management Services for Behavioral Health Conditions by Physician

Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements:
*Initial assessment or follow-up monitoring, including the use of applicable validated rating scales,
*Behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes,
*Facilitating and coordinating treatment such as psychotherapy, pharmacotherapy, counseling and/or psychiatric consultation, and
*Continuity of care with a designated member of the care team.

DMC, DMC-ODSClient EducationThe DHCS billing manual states that this should be utilized to submit claims for Patient Education Services. Per 15 minutes
DMC, DMC-ODSComprehensive Community SupportsServices 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.
DMC-ODSContingency ManagementThis procedure must be used to submit claims for Contingency Management Services. 15 minutes
MH, DMC, DMC-ODSCrisis Intervention/Mobile CrisisA service, lasting less than 24 hours, to or on behalf of a beneficiary for a condition that requires more timely response than a regularly scheduled visit. Service activities include but are not limited to one or more of the following: assessment, collateral and therapy. Clinical providers who are providing crisis intervention should consider whether Psychotherapy for Crisis would be a more appropriate code for the service rendered. Per 15 minutes
DMC, DMC-ODSDischarge PlanningUtilized when developing discharge summaries and/or discharge plans and reviewing these documents with the beneficiary.
DMC-ODSFamily Therapy - client not present"Family Therapy" services for the purposes of improving the beneficiary's functioning. The patient does not have to be present for this service. Therapy may be delivered to a beneficiary or group of beneficiaries and may include family therapy directed at improving the beneficiary’s functioning and at which the beneficiary is present. 26-50 minutes
MH, DMC-ODSFamily Therapy - client present"Family Therapy" services for the purposes of improving the beneficiary's functioning. The patient must be present for this service. Therapy may be delivered to a beneficiary or group of beneficiaries and may include family therapy directed at improving the beneficiary’s functioning and at which the beneficiary is present. 26-50 minutes
DMC, DMC-ODSFamily/Couple CounselingAlcohol and/or substance abuse services provided with a family/couple.
DMC, DMC-ODSGroup CounselingGroup counseling related to alcohol and/or drug services. 15 minutes
MHGroup TherapyDocuments provision of "typical" group therapy services that include multiple beneficiaries. Therapy may be delivered to a beneficiary or group of beneficiaries and may include family therapy directed at improving the beneficiary’s functioning and at which the beneficiary is present. 15 minutes
DMC-ODSHealth Behavior Intervention - with FamilyIncludes supporting improvements in function, minimizing psychological and/or psychosocial barriers to recovery, and improved coping skills related to medical conditions. Patient is not present. 16-30 minutes
DMC-ODSHealth Risk AssessmentAdministration and review/interpretation of findings related to health risk assessments.
DMC, DMC-ODSIndividual CounselingIndividual 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
MHIndividual Therapy'"Individual Therapy" services provided to a beneficiary focused primarily on symptom reduction and restoration of functioning as a means to improve coping and adaptation and reduce functional impairments. Therapeutic intervention includes the application of cognitive, affective, verbal or nonverbal strategies based on the principles of development, wellness, adjustment to impairment, recovery and resiliency to assist a beneficiary in acquiring greater personal, interpersonal and community functioning or to modify feelings, thought processes, conditions, attitudes or behaviors which are emotionally, intellectually, or socially ineffective. Each Psychotherapy with Patient CPT represents a specific length of time: 90832: 30 minutes, 90834: 45 minutes and 90837: 60 minutes. The beneficiary must be present for these services.
MH, DMC, DMC-ODSOral Medication AdministrationAdministration of oral medication with direct observation. 15 minutes. This code is also used by LVNs/LPTs and Pharmacists to document the administration of injectable medications.
MH, DMC-ODSMultiple-Family Group PsychotherapyA group therapy code that allows for documentation of groups that include multiple families vs. a single family. Therapy may be delivered to a beneficiary or group of beneficiaries and may include family therapy directed at improving the beneficiary’s functioning and at which the beneficiary is present. 15 minutes
MHPlan Development, non-physicianPlan Development means a service activity that consists of one or more of the following: development of client plans, approval of client plans and/or monitoring of a beneficiary’s progress. Physicians do not utilize this HCPCS code as Medication Support Services include plan development as a component of those services. 15 minutes
DMC-ODSPrenatal Risk AssessmentAdministration of risk assessment related to prenatal care.
DMC, DMC-ODSPsychoeducationIncludes providing information regarding mental illness and substance abuse and teaches problem-solving, communication, and coping skills to support recovery and resilience. Per 15 minutes
MH, DMC-ODSPsychosocial 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.

MH, DMC-ODSPsychosocial Rehabilitation Group

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.

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.

MHPsychotherapy for CrisisThe individual must be present for all or part of the service. Urgent assessment and exploration of an individual in crisis. Includes mental status exam as well as a disposition and treatment includes therapy, mobilization of resources and implementation of interventions to address the crisis. 30-74 minutes
DMC-ODSReport Generation for Care CoordinationUtilized to document preparing reports for other individuals, agencies, etc. for the purposes of care coordination.
MH, DMC, DMC-ODSReview of Hospital RecordsReview of records for psychiatric evaluation without direct patient contact. This may be accomplished at the request of an agency or peer review organization. 15 minutes
DMC, DMC-ODSSUD Crisis InterventionSUD 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.
DMC, DMC-ODSSUD ScreeningScreening to determine the appropriate services for an individual seeking treatment.
MHTBS"Therapeutic Behavioral Services (TBS) is an adjunctive program that supports other services patients are currently receiving. TBS is an intensive, individualized, one-to-one behavioral health service available to children/youth with serious emotional challenges and their families, who are under 21 years old and have full-scope Medi-Cal. Per 15 minutes. "
MHTCM/ICCServices 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.
MH, DMC-ODSTeam Case Conference with Client/Family absentDocuments medical team conference with interdisciplinary team, participation by non-physician. Patient and/or family not present. 30 minutes or more
MH Team Case Conference with Client/Family presentDocuments medical team conference with interdisciplinary team, participation by a non-physician. Face to face with patient and/or family present. 30 minutes or more