Certified Peer Specialist Services. The HMO may elect to provide an enhanced behavioral health benefit to eligible members through the use of Certified Peer Specialist providers. This benefit is available for BadgerCare Plus and/or Medicaid SSI HMO enrolled adults (18 years and older) with a mental health and/or substance abuse diagnosis, especially members with a co-morbid diagnosis, who are at risk of hospitalization or who may have been hospitalized. Peer Specialists will be supervised by the HMO rendering provider, who must be a qualified mental health professional. Peer Specialists will be certified and trained by the Department’s Division of Mental Health & Substance Abuse (DMHSAS). DMHSAS maintains oversight of the training, certification and supervision requirements for peer specialist providers eligible for providing this benefit to HMO members. Peer specialist services will be billed under their supervising clinician’s NPI, using HCPCS code H0038 – Self-help/peer services. Up to 16 units may be billed per week. A unit is 15 minutes. Travel time to and from the member visits may not be billed separately, this time considered covered within the direct time reimbursement.
Appears in 3 contracts
Samples: Contract for Badgercare Plus and/or Medicaid Ssi Hmo Services, Contract for Badgercare Plus and/or Medicaid Ssi Hmo Services, Contract for Badgercare Plus and/or Medicaid Ssi Hmo Services
Certified Peer Specialist Services. The HMO may elect to provide an enhanced behavioral health benefit to eligible members through the use of Certified Peer Specialist providers. This benefit is available for BadgerCare Plus and/or Medicaid SSI HMO enrolled adults (18 years and older) with a mental health and/or substance abuse diagnosis, especially members with a co-morbid diagnosis, who are at risk of hospitalization or who may have been hospitalized. Peer Specialists will be supervised by the HMO rendering provider, who must be a qualified mental health professional. Peer Specialists will be certified and trained by the Department’s Division of Mental Health & Substance Abuse Care and Treatment Services (DMHSASDCTS). DMHSAS DTCS maintains oversight of the training, certification and supervision requirements for peer specialist providers eligible for providing this benefit to HMO members. Peer specialist services will be billed under their supervising clinician’s NPI, using HCPCS code H0038 – Self-help/peer services. Up to 16 units may be billed per week. A unit is 15 minutes. Travel time to and from the member visits may not be billed separately, this time considered covered within the direct time reimbursement.
Appears in 3 contracts
Samples: Hmo Services Agreement, Contract for Badgercare Plus and/or Medicaid Ssi Hmo Services, Contract for Badgercare Plus and/or Medicaid Ssi Hmo Services
