Adult rehabilitative mental health services (ARMHS) are mental health services that are rehabilitative and enable the member to develop and enhance psychiatric stability, social competencies, personal and emotional adjustment, and independent living and community skills when these abilities are impaired by the symptoms of mental illness. The services also enable a member to retain stability and functioning if he or she is at risk of losing significant functionality or being admitted to a more restrictive service setting without these services. The services instruct, assist, and support a member in areas such as medication education and monitoring, and basic social and living skills in mental illness symptom management, household management, and employment-related or community living transitions.
Covered Services
The following seven services are billable as ARMHS:
- Basic living and social skills
- Certified peer specialist services
- Community intervention
- Functional assessment
- Individual treatment plan
- Medication education
- Transition to community living services.
All covered services are provided face-to-face except community intervention. Documentation of activities is included in the covered service and must not be billed separately.
ARMHS services may be provided in the following settings:
- A member’s home
- The home of a relative or significant other
- A member’s job site
- The community, such as any of the following:
- Psychosocial clubhouse
- Drop-in center
- Social setting
- Classroom
- Other place in the community
Do not provide ARMHS, except for services that meet the requirements under Transition to Community Living Services, to a member residing in any of the following:
- Regional treatment centers
- Nursing facilities
- Acute-care settings (inpatient hospital)
- Sub-acute settings (Intensive Residential Treatment Services [IRTS] program)
Basic Living and Social Skills
Basic living and social skills are activities that instruct, assist, and support a member in skill areas essential for everyday, independent living. Examples of skill areas include the following:
- Interpersonal communications
- Community resource utilization and integration
- Crisis assistance
- Relapse prevention
- Budgeting, shopping, and healthy lifestyle skills and practices
- Cooking and nutrition
- Transportation
- Medication monitoring
- Mental illness symptom management
- Household management
- Employment-related skills
- Transitioning to community living
Each member’s treatment plan should identify specific skills needed, how each is being addressed, the method (individually, group), and the medical necessity for each goal.
Provide basic living and social skills individually or in a group setting, when appropriate, to each participating member’s needs and treatment plan. A basic living and social skills group is two to 10 people, at least one of whom is an MA member. Up to two staff people may bill MHCP for services provided to a group. Each staff person must bill for different members.
Provide basic living and social skills directly (face-to-face) to the member. Do not bill if the contact is conducted by telephone.
Certified Peer Specialist Services
CPS services include the following:
- Non-clinical, recovery-focused activities encouraging empowerment, self-determination, and decision-making, which are only provided by a CPS
- Activities that can address and contribute to the ARMHS team insights about feelings associated with stigma, social isolation, personal loss, systemic power dynamics and restoring one’s lifestyle following hospitalization, or other acute care services
A CPS Level I cannot develop the Functional Assessment, Interpretive Summary (IS), LOCUS and the ITP. A co-signature is not needed on the progress note.
Refer to the Certified Peer Specialist Services section of this manual for more information.
Community Intervention
Community intervention is a service of strategies provided on behalf of a member to do the following:
- Alleviate or reduce a member’s barriers to community integration or independent living
- Minimize the risk of hospitalization or placement in a more restrictive living arrangement
Community intervention may be conducted with an agency, institution, employer, landlord or member’s family and may require the involvement of the member’s relatives, guardians, friends, employer, landlord, treatment providers or other significant people to change situations and allow the member to function more independently.
Delivery of community intervention services meets the following:
- Must be directed exclusively to the treatment of the member
- Must be provided on an individual basis only (cannot be provided in a group)
- May be conducted in person or by telephone if the intervention strategy warrants it (document accordingly)
- May be conducted without the member present when the intervention strategy warrants it (document why the strategy is more effective without the member present) Do not bill community intervention for the following reasons:
- Routine communication between members of a treatment team, a routine staffing or a care conference
- Telephone contacts that do not conform to the definition of this service or that are not properly documented
- Clinical supervision or consultation with other professionals
- Treatment plan development