Alaska Administrative Code › Title 7 - Health and Social Services › Part 8 - Medicaid Coverage and Payment › Chapter 135 - Medicaid Coverage; Behavioral Health Services › Article 1 - Scope; Eligibility; Enrollment; Authorization › 7 AAC 135.040 - Service authorization and limitation

Current through May 31, 2024
(a) Except as
				  provided in (b) and (c) of this section and
				  7 AAC 105.130(d), the department will
				  not pay for behavioral health services unless the department has given prior
				  authorization for those services.
(b) A community behavioral health services
				  provider or mental health physician clinic may provide the following behavioral
				  health clinic services without prior authorization from the department:
(1) a combination of individual, group, and
				  family psychotherapy, not to exceed 30 hours for each recipient in a state
				  fiscal year;
(2) psychiatric
				  assessments under
				  7 AAC 135.110(e), not to exceed four
				  per recipient in a state fiscal year;
(3) psychological testing and evaluation
				  under 7 AAC 135.110(g),
				  not to exceed six hours per recipient in a state fiscal year, except that
				  neuropsychological testing and evaluation is limited to 12 hours per recipient
				  in a state fiscal year if the provider has documentation validating the
				  provider's qualifications to provide neuropsychological testing and evaluation
				  services;
(4) pharmacologic
				  management services, not to exceed one visit per recipient per week during the
				  first four weeks after the recipient begins receiving pharmacologic management
				  services, and, thereafter, not to exceed one visit per recipient per month as
				  long as the recipient is receiving a service under this chapter, unless more
				  frequent monitoring is required because of
(A) the requirements of the specific
				  medication; or
(B) a recipient's
				  unusual clinical reaction to a medication;
(5) if the individual is not already
				  receiving services under this chapter at the time the assessment is provided
				  under this paragraph, one integrated mental health and substance use intake
				  assessment under
				  7 AAC 135.110, or a combination of one mental health
				  intake assessment and one substance use intake assessment under
				  7 AAC 135.110; the assessment or combination of
				  assessments must consist of
(A) one or more
				  face-to-face sessions; and
(B) a
				  review of collaterally connected information;
(6) based on a current behavioral health
				  treatment plan, one integrated mental health and substance use intake
				  assessment under
				  7 AAC 135.110, or a combination of one mental health
				  intake assessment and one substance use intake assessment under
				  7 AAC 135.110, every six months;
(7) short-term crisis intervention services
				  under 7 AAC 135.160, or a combination of
				  behavioral health clinic service, rehabilitation service, and intervention
				  service under
				  7 AAC 135.010 that are included in the crisis plan, that
				  do not exceed 22 hours of the total short-term crisis intervention services
				  provided to a recipient during a state fiscal year;
(8) screening and brief intervention
				  services, with no limit.