nutritional requirements, based on recognized scientific 
principles, are established by medical evaluation. 
(f) MENTAL
HEALTH
AND
SUBSTANCE
ABUSE 
TREATMENT SERVICES.— 
(1) SERVICES
DESCRIBED.—In this title, the 
term ‘‘mental health and substance abuse treatment 
services’’ means the following services related to the 
prevention, diagnosis, treatment, and rehabilitation 
of mental illness and promotion of mental health: 
(A) INPATIENT HOSPITAL SERVICES.—In-
patient hospital services furnished primarily for 
the diagnosis or treatment of mental illness or 
substance abuse for up to 60 days during a 
year, reduced by a number of days determined 
by the Secretary so that the actuarial value of 
providing such number of days of services 
under this paragraph to the individual is equal 
to the actuarial value of the days of inpatient 
residential services furnished to the individual 
under subparagraph (B) during the year after 
such services have been furnished to the indi-
vidual for 120 days during the year (rounded to 
the nearest day), but only if (with respect to 
services furnished to an individual described in 
section 204(b)(1)) such services are furnished 
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in conformity with the plan of an organized sys-
tem of care for mental health and substance 
abuse services in accordance with section 
204(b)(2). 
(B) INTENSIVE RESIDENTIAL SERVICES.— 
Intensive residential services (as defined in 
paragraph (2)) furnished to an individual for 
up to 120 days during any calendar year, ex-
cept that— 
(i) such services may be furnished to 
the individual for additional days during 
the year if necessary for the individual to 
complete a course of treatment to the ex-
tent that the number of days of inpatient 
hospital services described in subparagraph 
(A) that may be furnished to the individual 
during the year (as reduced under such 
subparagraph) is not less than 15; and 
(ii) reduced by a number of days de-
termined by the Secretary so that the actu-
arial value of providing such number of 
days of services under this paragraph to 
the individual is equal to the actuarial 
value of the days of intensive community- 
based services furnished to the individual 
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under subparagraph (D) during the year 
after such services have been furnished to 
the individual for 90 days (or, in the case 
of services described in subparagraph 
(D)(ii), for 180 days) during the year 
(rounded to the nearest day). 
(C) OUTPATIENT
SERVICES.—Outpatient 
treatment services of mental illness or sub-
stance abuse (other than intensive community- 
based services under subparagraph (D)) for an 
unlimited number of days during any calendar 
year furnished in accordance with standards es-
tablished by the Secretary for the management 
of such services, and, in the case of services fur-
nished to an individual described in section 
204(b)(1) who is not an inpatient of a hospital, 
in conformity with the plan of an organized sys-
tem of care for mental health and substance 
abuse services in accordance with section 
204(b)(2). 
(D) INTENSIVE COMMUNITY-BASED SERV-
ICES.—Intensive community-based services (as 
described in paragraph (3))— 
(i) for an unlimited number of days 
during any calendar year, in the case of 
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services described in section 1861(ff)(2)(E) 
that are furnished to an individual who is 
a seriously mentally ill adult, a seriously 
emotionally disturbed child, or an adult or 
child with serious substance abuse disorder 
(as determined in accordance with criteria 
established by the Secretary); 
(ii) in the case of services described in 
section 1861(ff)(2)(C), for up to 180 days 
during any calendar year, except that such 
services may be furnished to the individual 
for a number of additional days during the 
year equal to the difference between the 
total number of days of intensive residen-
tial services which the individual may re-
ceive during the year under part A (as de-
termined under subparagraph (B)) and the 
number of days of such services which the 
individual has received during the year; or 
(iii) in the case of any other such 
services, for up to 90 days during any cal-
endar year, except that such services may 
be furnished to the individual for the num-
ber of additional days during the year de-
scribed in clause (ii). 
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(2) INTENSIVE
RESIDENTIAL
SERVICES
DE-
FINED.— 
(A) IN
GENERAL.—Subject to subpara-
graphs (B) and (C), the term ‘‘intensive resi-
dential services’’ means inpatient services pro-
vided in any of the following facilities: 
(i) Residential detoxification centers. 
(ii) Crisis residential programs or 
mental illness residential treatment pro-
grams. 
(iii) Therapeutic family or group 
treatment homes. 
(iv) Residential centers for substance 
abuse treatment. 
(B) REQUIREMENTS FOR FACILITIES.—No 
service may be treated as an intensive residen-
tial service under subparagraph (A) unless the 
facility at which the service is provided— 
(i) is legally authorized to provide 
such service under the law of the State (or 
under a State regulatory mechanism pro-
vided by State law) in which the facility is 
located or is certified to provide such serv-
ice by an appropriate accreditation entity 
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approved by the State in consultation with 
the Secretary; and 
(ii) meets such other requirements as 
the Secretary may impose to assure the 
quality of the intensive residential services 
provided. 
(C) SERVICES
FURNISHED
TO
AT-RISK 
CHILDREN.—In the case of services furnished 
to an individual described in section 204(b)(1), 
no service may be treated as an intensive resi-
dential service under this subsection unless the 
service is furnished in conformity with the plan 
of an organized system of care for mental 
health and substance abuse services in accord-
ance with section 204(b)(2). 
(D) MANAGEMENT STANDARDS.—No serv-
ice may be treated as an intensive residential 
service under subparagraph (A) unless the serv-
ice is furnished in accordance with standards 
established by the Secretary for the manage-
ment of such services. 
(3) INTENSIVE
COMMUNITY-BASED
SERVICES 
DEFINED.— 
(A) IN
GENERAL.—The term ‘‘intensive 
community-based services’’ means the items 
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