Psychiatric Health Facility Services definition

Psychiatric Health Facility Services means therapeutic and/or rehabilitative services provided in a psychiatric health facility, other than a psychiatric health facility that has been certified by the State Department of Health Services as a Medi-Cal provider of inpatient hospital services, on an inpatient basis to beneficiaries who need acute care, which is care that meets the criteria of Section 1820.205, and whose physical health needs can be met in an affiliated general acute care hospital or in outpatient settings.

Psychiatric Health Facility Services are therapeutic and/or rehabilitative services provided in a psychiatric health facility on an inpatient basis to beneficiaries who need acute care, which meets the criteria of Section 1820.205 of Chapter 11, Division 1, Title 9 of the California Code of Regulations, and whose physical health needs can be met in an affiliated general acute care hospital or in outpatient settings. These services are separate from those categorized as “Psychiatric Inpatient Hospital”.

Examples of Psychiatric Health Facility Services in a sentence

• Mental Health Services are not reimbursable on days when Inpatient Services in an acute hospital or Psychiatric Health Facility Services are reimbursed, except for the day of admission to those services.

• Day Treatment Services are not reimbursable on days when Crisis Residential Treatment Services, Inpatient Services, or Psychiatric Health Facility Services are reimbursed, except for the day of admission to those services.

• For the following subset of rehabilitative mental health services – Adult Residential Treatment Services, Crisis Residential Treatment Services, services provided in a treatment foster home and Psychiatric Health Facility Services – allowable costs are determined in accordance to the reimbursement principle in title 42 CFR 413, OMB Circular A-87 and CMS Medicaid non-institutional reimbursement policy.

• Lockouts for Targeted Case Management Services (a) Targeted Case Management Services are not reimbursable on days when the following services are reimbursed, except for day of admission or for placement services as provided in Subsection (b): (1) Psychiatric Inpatient Hospital Services; (2) Psychiatric Health Facility Services; (3) Psychiatric Nursing Facility Services.

• TBS services are not reimbursable on days when Inpatient Services in an acute hospital or Psychiatric Health Facility Services are reimbursed, except for the day of admission to those services.

• Day Rehabilitation and Day Treatment Intensive are not reimbursable under the following circumstances: (a) When Crisis Residential Treatment Services, Psychiatric Inpatient Hospital Services, Psychiatric Health Facility Services or Psychiatric Nursing Facility Services are reimbursed, except for the day of admission to those services.

• Medication Support Services are not reimbursable on days when Crisis Residential Treatment Services, Inpatient Services, or Psychiatric Health Facility Services are reimbursed, except for the day of admission to those services.

• The items below are only key factors in the proposal to provide Psychiatric Health Facility Services for Department of Behavioral Health and Recovery Services.

• Rehabilitation and Day Treatment Intensive are not reimbursable under the following circumstances: (a) When Crisis Residential Treatment Services, Psychiatric Inpatient Hospital Services, Psychiatric Health Facility Services or Psychiatric Nursing Facility Services are reimbursed, except for the day of admission to those services.

• Service Reimbursement by Calendar Days (§1840.320): This applies to:⇒ Adult Residential Treatment Services (Transitional and Long-Term)⇒ Crisis Residential Treatment Services⇒ Psychiatric Health Facility Services Claiming Rules (§1840.320): ⇒ A day shall be billed for each calendar day in which the client receives face-to-face services and the client has been admitted to the program.