The Mental Health Services Division oversees the following programs:
- Acute freestanding psychiatric facilities
- Community/private mental health centers
- Therapeutic and evaluative mental health services
- Outpatient mental health hospital services
- Pre-admission screening and resident review
- Psychiatric residential treatment facilities
- Psychiatric units at general hospitals
Acute Freestanding Psychiatric Facilities
Acute Freestanding Psychiatric Facilities provide acute services for children under 21, with an average length of stay of 7-10 days. Prior authorization is required.
Community/Private Mental Health Center Services
Community/private mental health centers provide mental health services to children and adults. Services may be provided at regional community mental health centers, private mental health centers, or community services division of a state hospital.
Therapeutic and Evaluative Mental Health Services
Therapeutic and Evaluative Mental Health Services (T & E) are a component of the Expanded Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program for beneficiaries under the age of twenty one (21), and are managed by the Office of Mental Health. The service ends on the last day of the 21st birthday month. All services must be medically necessary. Some services require prior authorization from the Division of Medicaid’s designated Utilization Management Quality Improvement Organization (UMQIO) or the appropriate Coordinated Care Organization (CCO), whichever is applicable. Service standards do apply, yet may be exceeded with proper prior authorization.
- Provider Guidance: Therapeutic and Evaluative Mental Health Services (T&E) for Expanded Early and Periodic Screening, Diagnosis and Treatment (EPSDT)
Outpatient Mental Health Hospital Services
Outpatient Mental Health Hospital Services are covered when provided in an outpatient department of a general hospital. Services are not covered at acute freestanding psych facilities.
Pre-Admission Screening and Resident Review (PASRR)
Pre-Admission Screening and Resident Review (PASRR) is an administrative activity that helps to ensure that an individual is appropriate for nursing facility placement and aids in determining whether an individual with an indication of Mental Illness, Intellectual Disability and/or a related condition could benefit from specialized or rehabilitative services. Specialized services are any individualized services or supports that supplement the scope of services normally provided by a nursing facility. The screenings and resident reviews are conducted by the DOM PASRR Contractor, and/or one of the DMH regional centers located throughout the state. Should it be determined that an individual would benefit from specialized and/or rehabilitative services, it is the nursing facility’s responsibility to ensure that specialized and/or rehabilitative services are made available and/or provided to the resident, based on his or her individual needs.
Psychiatric Residential Treatment Facilities (PRTF)
Psychiatric residential treatment facilities are residential services for children under 21, with an average length of stay of 6 months. Prior authorization is required.
- PRTF providers: document for public use, updated Feb. 4, 2015
Psychiatric Units at General Hospitals
Psychiatric units at general hospitals provide acute psychiatric services for both children and adults, with an average length of stay of 7-10 days. There is a limit of 30 days per fiscal year for adults. Children may have more days, if medically necessary. Prior authorization is required.