Section 140.452  Community-based Mental Health Providers Qualified for Payment

a)         Payment will be made for community-based mental health services provided by providers enrolled in the Illinois Medical Assistance Program as:

1)         A Community Mental Health Center. Community Mental Health Center shall mean an entity certified by the Department, or its agent, pursuant to 59 Ill. Adm. Code 132; or

2)         A Behavioral Health Clinic, pursuant to Section 140.499; or

3)         An Independent Practitioner defined as:

A)        A Licensed Clinical Psychologist, pursuant to 89 Ill. Adm. Code 140.423(a);

B)        A Licensed Clinical Social Worker, pursuant to 89 Ill. Code 140.424(a); or

C)        A psychiatrist, defined as a physician licensed under the Medical Practice Act of 1987 who has successfully completed a training program in psychiatry approved by the Accreditation Council for Graduate Medical Education (ACGME) or other training program identified as equivalent by the Department.

b)         To receive payment for community-based mental health services, providers must be enrolled for participation in the Medical Assistance Program, pursuant to Sections 140.11 and 140.12.

c)         Community Mental Health Centers may receive reimbursement for all services described in Section 140.454.

d)         Behavioral Health Clinics may receive reimbursement for all services described in Section 140.454, except Behavioral Health Clinics may not receive reimbursement for the services described in the following subsections of Section 140.453:  Assertive Community Treatment (Section 140.453(d)(4)(A)) and Psychosocial Rehabilitation (Section 140.453(d)(2)(F)).

e)         Independent Practitioners may receive reimbursement only for the following services: Integrated Assessment and Treatment Planning (Section 140.453(d)(1)); Therapy/Counseling (Section 140.453(d)(2)(G)); and MRO Crisis Services (Section 140.453(d)(3)).

(Source:  Amended at 43 Ill. Reg. 6736, effective May 28, 2019)