Common use of Covered Behavioral Health Services Clause in Contracts

Covered Behavioral Health Services. The Contractor shall assure the provision of all Medically Necessary Behavioral Health Services for Members. These services are described in Appendix H. “Covered Services.” All Behavioral Health services shall be provided in conformance with the access standards established by the Department. When assessing Members for Behavioral Health Services, the Contractor and its providers shall use the most current version of DSM classification. The Contractor may require use of other diagnostic and assessment instrument/outcome measures in addition to the most current version of DMS. Providers shall document DSM diagnosis and assessment/outcome information in the Member’s medical record.

Covered Behavioral Health Services. The Contractor shall assure the provision of all Medically Necessary Behavioral Health Services for Members. These services are described in Appendix H. I. “Covered Services.” All Behavioral Health services shall be provided in conformance with the access standards established by the Department. When assessing Members for Behavioral Health Services, the Contractor and its providers shall use the most current version of DSM DSM-V classification. The Contractor may require use of other diagnostic and assessment instrument/outcome measures in addition to the most current version of DMS. -V. Providers shall document DSM DSM-V diagnosis and assessment/outcome information in the Member’s medical record.