405 Ind. Admin. Code 5-21.6-11

Current through January 8, 2025

Section 405 IAC 5-21.6-11 - Therapy and behavioral support services

Authority: IC 12-8-6.5-5; IC 12-15

Affected: IC 12-13-7-3; IC 12-29; IC 25-23-1-1; IC 25-23.6-10.5; IC 25-27.5-5

Sec. 11.

(a) The services reimbursable as therapy and behavioral support services include the following:

(1) Services provided in an individual or a group setting.

(2) Services provided to family members or other nonprofessional caregivers in an individual or group setting, with or without the member present.

(b) Services provided to a member must be:

(1) time-limited;

(2) structured; and

(3) provided in a face-to-face session.

(c) Services provided must meet the following requirements:

(1) Be provided either at home or at locations outside the clinic setting.

(2) Be provided in an individual setting or a group setting.

(3) Be a face-to-face interaction with the member, family members, or nonprofessional caregivers supporting a member.

(4) The member must be the focus of the service.

(d) Provider staff delivering services under this subsection must meet one (1) of the following qualifications:

(1) Be a licensed professional, as defined in this rule, except not a licensed clinical addiction counselor as defined under IC 25-23.6-10.5.

(2) Be a QBHP.

(e) Therapy and behavioral support service standards include the following:

(1) Observation of the member and environment for purposes of the development of the IICP.

(2) Development of a person-centered behavioral support plan and subsequent revisions that may be a part of the IICP.

(3) Therapy and support activities include, but are not limited to, the following:

(A) Assertiveness training.

(B) Stress reduction techniques.

(C) Development of socially accepted behaviors.

(D) Implementation of a behavior support plan for staff, family members, roommates, and other appropriate individuals.

(f) The services are not reimbursable under this section if provided in a clinic setting.

405 IAC 5-21.6-11

Office of the Secretary of Family and Social Services; 405 IAC 5-21.6-11; filed Dec 16, 2013, 9:11 a.m.: 20140115-IR-405130183FRA

Filed 8/1/2016, 3:44 p.m.: 20160831-IR-405150418FRA

Readopted filed 7/28/2022, 2:21 p.m.: 20220824-IR-405220205RFA

Readopted filed 5/30/2023, 11:54 a.m.: 20230628-IR-405230292RFA