Virginia Regulatory Town Hall
Department of Medical Assistance Services
Board of Medical Assistance Services
Amount, Duration, and Scope of Medical and Remedial Care and Services [12 VAC 30 ‑ 50]
Action Mental Health Skill-building Services
Stage Proposed
Comment Period Ended on 10/23/2015
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9/21/15  12:01 pm
Commenter: Heather Rupe, Co-Chair VACSB Qualtiy Leadership Committee

MHSB Assessment Reimbursement Rate/Structure

Proposed Language:

1. Prior to At admission, an appropriate face-to-face service-specific provider intake must be completed, conducted, documented, signed, and dated, and documented by the LMHP, LMHP-supervisee, LMHP-resident, or LMHP-RP indicating that service needs can best be met through mental health support services. Providers shall be reimbursed one unit for each intake utilizing the appropriate billing code. Service-specific provider intakes shall be repeated when the individual receives six months of continual care and upon any lapse in services of more than 30 calendar days.


The regulation reads that the rate for the SSPI assessment is equal to one unit. In these proposed regulations one unit is 15 minutes. Under the new system, the rate for one 15-munite unit would be $14.77 in urban areas and $13.47 in rural areas.


Its unlikely that an SSPI be completed in a 15 minute unit.  Recommend reimbursement for full hour of assessment equal to 4 (15 min ) units.

CommentID: 42174