Code of Massachusetts Regulations › 130 CMR - DIVISION OF MEDICAL ASSISTANCE › Title 130 CMR 434.000 - Psychiatric Hospital Outpatient Services › Section 434.402 - Definitions

Current through Register 1525, July 5, 2024
The following terms used in
				130 CMR 434.000 have the
				meanings given in 130 CMR 434.402 unless the context clearly requires a
				different meaning.
Child and Adolescent Needs and
				Strengths
- a tool that provides a standardized way to organize
				information gathered during behavioral-health clinical assessments. A
				Massachusetts version of the tool has been developed and is intended to be used
				as a treatment decision support tool for behavioral-health providers serving
				MassHealth members under the age of 21.
Couple Therapy
- for the purposes of
				mental health services, therapeutic services provided to a couple whose primary
				complaint is the disruption of their marriage, family, or relationship.
Crisis Intervention/Emergency Services
- immediate mental health evaluation, diagnosis, hospital prescreening,
				treatment, and arrangements for further care and assistance as required,
				provided during all hours to members showing sudden, incapacitating emotional
				stress.
Diagnostic Services
- for the purposes
				of mental health services, the examination and determination of a patient's
				psychological, social, economic, educational, and vocational assets and
				disabilities for the purpose of designing a treatment plan.
Family Consultation
- a preplanned
				meeting with a parent, foster parent, legal guardian, or caretaker of a child
				or adolescent who is being treated, when the parent, foster parent, legal
				guardian, or caretaker is not the focus of the meeting.
Family Therapy
- for the purposes of
				mental health services, the treatment of more than one member of a family
				simultaneously in the same session.
Group Therapy
- for the purposes of
				mental health services, the application of psychotherapeutic or counseling
				techniques to a group of persons, most of whom are not related by blood,
				marriage, or legal guardianship.
Individual Therapy
- for the purposes
				of mental health services, a therapeutic service provided to an
				individual.
Institutionalized Individual
- an
				individual who is either
(1) involuntarily confined or detained under a civil or
				criminal statute in a correctional or rehabilitative facility, including a
				psychiatric hospital or other facility for the treatment of mental illness;
				or
(2) confined under a voluntary commitment in a psychiatric
				hospital or other facility for the care and treatment of mental illness.
Maintenance Therapy
- repetitive
				therapy that is performed when a person can progress no further toward
				functional independence but that is or may be necessary to prevent
				regression.
Medication Visit
- for the purposes of
				mental health services, a member visit specifically for the prescription,
				review, and monitoring of medication by a licensed psychiatrist or licensed
				clinician with prescriptive authority or for the administration of prescribed
				intramuscular medication by a licensed nurse or physician.
Mental Illness
- mental and emotional
				disorders as defined in the current American Psychiatric Association's
Diagnostic and Statistical Manual of Mental Disease
, 4th
				edition (DSM-IV).
Psychiatric Hospital Outpatient
				Services
- services provided to members on an outpatient basis in
				a psychiatric inpatient hospital.
Psychiatric Inpatient Hospital
- any
				psychiatric facility or inpatient program in a licensed psychiatric facility
				that has six beds or more for inpatient use, is certified by the Massachusetts
				Department of Public Health for participation in Medicare, and primarily treats
				patients whose principal diagnosis is based on the DSM-IV. For out-of-state
				psychiatric inpatient hospital providers, certification for participation in
				MassHealth by the appropriate state agency may be substituted. "Primarily
				treats" means that, over a six-month period, inpatient care has been provided
				to a patient population of which 51% or more consistently have a principal
				diagnosis that is psychiatric.
Psychiatric Outpatient Visit
- a
				psychiatric hospital outpatient service involving a face-to-face encounter
				between an eligible member and a licensed practitioner for diagnosis,
				examination, or treatment.
Psychological Testing
- the use of
				standardized test instruments by a licensed psychologist to evaluate aspects of
				an individual's functioning, including aptitudes, educational achievements,
				cognitive processes, emotional conflicts, and type and degree of
				psychopathology, subject to the limitations of 130 CMR 434.480(H).
Short-term Therapy
- for the purposes
				of mental health services, a combination of diagnostics and individual, couple,
				family, and group therapy planned to end within 12 sessions.