3 Miss. Code R. § 1-03-302

Current through May 31, 2024
Section 3-1-03-302 - Mental Health Counseling and Care
1. Victim/Claimant Eligibility:
a. The victim/claimant must otherwise qualify for compensation before any award can be considered;
b. The victim/claimant must have suffered personal injury or psychological trauma as a direct result of the criminally injurious conduct; and,
c. Counseling must be causally related to the crime and focus must be for treatment to assist in the victim's/claimant's recovery.
d. An individual who witnesses a violent crime and suffers psychological trauma may receive mental health benefits.
2. Family Member Eligibility:
a. The victim/claimant must otherwise qualify for compensation before any award can be considered;
b. The victim/claimant must have suffered death, personal injury or psychological trauma as a direct result of the criminally injurious conduct; and
c. Counseling must be causally related to the crime and focus must be for treatment to assist in the recovery of the victim's family member.
3. Verification: Supporting documentation as determined by the Division shall be submitted to verify and substantiate the expense eligibility. In order for the victim, claimant, or mental health provider to receive reimbursement for services, the following shall apply:
a. The victim/claimant shall provide an itemized bill, on provider letterhead, indicating date(s) of service, procedure code(s), and charge for each session.
b. The mental health provider shall provide a completed Mental Health Services and Expenses Report form to include: the presenting problem/complaint; assurance that the therapy is directly related to the crime; a treatment statement summary for dates of service, a legible copy of their professional license or certification (Advanced Practice Registered Nurse). The mental health provider shall also submit a (current) itemized bill detailing date(s) of service, procedure code(s), charge for each session, and source and amount of any payments received by the mental health provider.
c. The mental health provider must submit a completed W-9 Form/Request for Taxpayer Identification Number and Certification Form if one is not already on file. Additional documentation may be required as needed by the Mississippi Department of Finance and Administration.
d. The victim/claimant shall provide collateral source information.
e. Additional information and supporting documentation may be required from the mental health provider on an as-needed basis for further determination of expense eligibility.
4. Mental health services and limitations:
a. Compensation for mental health counseling and care for the victim/claimant and the victim's family members may not exceed Three Thousand Five Hundred Dollars ($3,500.00); provided, however, if there is more than one (1) family member per victim, the amount of compensation awarded shall be prorated among the family members not to exceed Three Thousand Five Hundred Dollars ($3,500.00).
b. Treatment must follow an accepted modality for the treatment of crime victims as determined by the Division of Victim Compensation.
c. If treatment addresses issues not directly related to the crime, then only that percentage of treatment which addressed the victimization shall be compensated.
d. Expenses for intake services (initial session CPT code 90801) will be reimbursed at the following rates: Master Level Clinicians: One Hundred Dollars ($100.00); Ph.D.: One Hundred Twenty Five Dollars ($125.00); M.D.: One Hundred Fifty Dollars ($150.00).
e. Expenses for evaluation and testing may not exceed One Hundred Fifty Dollars ($150.00). Exception: Expenses for evaluation and testing that exceed $150.00 will be considered on a case-by-case basis. If evaluation and testing expenses over $150.00 are determined reasonable and necessary, compensation for evaluation and testing then may not exceed Four Hundred Fifty Dollars ($450.00).
f. Allowable expenses for individual counseling sessions are based upon applicable licensure and/or certification requirements of the therapist/counselor, see § 302 (7).
g. Family counseling sessions are eligible only if the victim/claimant is present in the session and the focus is to assist in the victim/claimants recovery. Allowable expenses for family counseling sessions are based upon applicable licensure and/or certification requirements of the therapist/counselor, see § 302 (7). Exception: Parents/guardians of the victim may be seen for child-related content (inclusive of information about the childs condition, treatment, and concerns).
h. Expenses for group sessions may not exceed $40.00 per session.
i. Case management or staff conferences may not exceed $20.00 per session, per month.
j. Medication management and evaluation sessions may not exceed $40.00 per 15-20 minute session.
k. Medical and Mental Health Counseling transportation have a combined cap of Five Hundred Dollars ($500.00). This amount is in addition to the Fifteen Thousand Dollars ($15,000.00) Medical maximum or Three Thousand Five Hundred Dollars ($3,500.00) Mental Health Counseling maximum.
5. Additional limitations and verification:
a. Sliding scale fees are to be based on the victim/claimants or family members income and only that portion will be eligible for compensation.
b. Counselors who are funded in whole or used as match funds for federal, state or local grant funds shall not be eligible for compensation payments, see § 209 (8).
c. Additional information and supporting documentation may be required from the mental health provider on an as needed basis for further determination of expense eligibility.
6. Ineligible expenses:
a. Preparation of reports and court support time;
b. Expenses for missed or canceled appointments;
c. Treatment for pre-existing physical or emotional conditions, unless the crime related trauma has exacerbated the pre-existing condition(s), expenses will be paid at the following rates: 1st three months (from date of crime) reimbursed at 100%; 2nd three months reimbursed at 50%. Thereafter, expenses are not eligible for reimbursement unless a qualified mental health provider (See § 302 [7]) can verify continued crime related trauma exacerbation of a pre-existing condition(s). A medical doctor or doctor of osteopathy licensed to practice medicine (see medical personnel exception in § 301 [10] [g]) may also be required to verify continued crime related trauma exacerbation of a pre-existing condition(s).
d. Services and/or products provided at no cost to the victim/claimant or family member; and,
e. Sessions in which the offender is present.
7. Qualified Mental Health Providers and Fee Schedule:
a. Mental health providers must meet or exceed the applicable licensure and/or certification requirements of Mississippi and expenses are awarded at the following rates, for the standard hourly individual or family session:

i. Licensed Psychiatrist, (M.D.)....................................................................... $120.00
ii. Licensed Psychologist (Ph.D.)..................................................................... $100.00
iii. Licensed Certified Social Worker:
1. (LCSW).......................................................................................................$ 80.00
2. (Ph.D.)......................................................................................................... $100.00
iv. Licensed Master Social Worker (LMSW).......................................................... $ 60.00
v. Licensed Professional Counselor:
1. (Master Level).....................$ 80.00
2. (Ph.D. Level) ......................$100.00
vi. Licensed Marital and Family Therapist (LMFT)................................. $ 80.00
vii. Licensed Art Therapist (LPAT) ......................................................... $ 80.00
viii. Advanced Practice Registered Nurse Psychiatric/
1. Mental Health Licensure...............................................................$ 80.00

b. Providers whose credentials are not recognized in the above are not eligible as a qualified mental health provider.
c. Mental health providers not licensed in Mississippi, may be considered as qualified providers in certain circumstances. Those individuals shall be supervised by a qualified mental health professional as listed above. The non-licensed provider must submit formal documentation indicating that supervision was provided and/or supervisory conferences were held. The Division will determine on a case-by-case basis whether the provider will be considered as a qualified mental health provider. If the non-licensed mental health provider meets these requirements, the fee schedule will be fifty percent (50%) less than the supervising qualified mental health provider.
d. Mental health providers not practicing in Mississippi must meet or exceed those qualifications of licensure requirements of Mississippi.
e. Individuals providing services through a student internship or other academic requirements are not eligible as a qualified mental health provider.
f. See § 302 (4) (d) for initial session (CPT code 90801) fee schedule.
8. Other mental health care benefits:
a. In-patient mental health services for the victim/claimant or the victim/claimant's family members are considered as mental health counseling and care expenses and the maximum of Three Thousand Five Hundred Dollars ($3,500.00) shall be applied.
b. Expenses incurred by victim/claimants and/or family members receiving medical attention for anxiety, depression and other related conditions, including medications, are considered mental health care expenses and the maximum of Three Thousand Five Hundred Dollars ($3,500.00) shall be applied.

3 Miss. Code. R. § 1-03-302