405 Ind. Admin. Code 5-21.6-12

Current through December 4, 2024

Section 405 IAC 5-21.6-12 - Addiction counseling 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. 12.

(a) The services reimbursable as addiction counseling services include the following:

(1) Services provided to the member either individually or in 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 shall meet the following standards:

(1) Be provided face-to-face with the member, family members, or nonprofessional caregivers.

(2) Be provided by qualified addiction professionals or other clinicians.

(3) Include any of the following:

(A) Education on addiction disorders.

(B) Skills training in:

(i) communication;

(ii) anger management;

(iii) stress management; and

(iv) relapse prevention.

(C) Referral to community recovery support programs, if available.

(c) Services under this section may be provided to adult members with:

(1) a substance-related disorder; and

(2) any of the following:

(A) Minimal or manageable medical conditions.

(B) Minimal withdrawal risk.

(C) Emotional, behavioral, and cognitive conditions that will not prevent the member from benefitting from this service.

(d) All services may be provided in an individual or group setting, but the member must always be the focus of addiction counseling.

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

(1) A licensed professional as defined under this rule.

(2) A QBHP.

(f) The following services are not reimbursable under this section:

(1) Services provided to a member with withdrawal risk or symptoms.

(2) Services provided to a member:

(A) whose needs cannot be managed safely with AMHH services; or

(B) who needs detoxification services.

(3) Services provided to a member who is determined to be at imminent risk of harm to the self or to others.

(4) Addiction counseling sessions that consist only of education.

(5) Services provided to professional caregivers.

405 IAC 5-21.6-12

Office of the Secretary of Family and Social Services; 405 IAC 5-21.6-12; 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