COMPASS MENTAL HEALTH, LLC

Compass Mental Health, LLC Providing Direction & Discovering Purpose

Emergency Behavioral Health Care, Crisis Intervention Services
Crisis Intervention Services General Definition Crisis intervention services provided by a mobile team or individual who travels to the place where the person is having the crisis (e.g., person’s place of residence, emergency room, community setting). Crisis intervention services include risk analysis, assessment, and crisis counseling services, de-escalation, critical incident debriefing, and consultation, if necessary with a higher-level behavioral health professional. Depending on the situation, the person may be transported to a more appropriate facility for further care. (e.g., a crisis services center) Service Standards/Provider Qualifications Crisis intervention services must be provided by agencies that have an Office of Behavioral Health Licensure license.

HCPCS / HIPAA Code H2011
Description		CRISIS INTERVENTION SERVICE, PER 15 MINUTES
New Rate		$27.00
Procedure DailyUnit Max		40
Place of Service		11, 12, 23, 50, 53, 54, 71, 72, 99
COS		47
Provider Type		02, 71, 77, B5, B6, B7

" Emergency medical condition" means a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain, psychiatric disturbances, and/or symptoms of substance abuse) such that the absence of immediate medical attention could reasonably be expected to result in:

o Placing the health of the individual in serious jeopardy

o Serious impairment to any bodily functions

o Serious dysfunction of any bodily organ or part

Some intoxicated individuals may meet the definition of " emergency medical condition" because the absence of medical treatment may place their health in serious jeopardy, result in serious impairment of bodily functions, or serious dysfunction of a bodily organ. Further, it is not unusual for intoxicated individuals to have unrecognized trauma.

Likewise, an individual expressing suicidal or homicidal thoughts or gestures, if determined dangerous to self or others, would be considered to have an emergency medical condition.

Sanctions: Medicaid MCOs that fail to cover emergency screening or stabilization services may be subject to intermediate sanctions or termination. Section 1932(e) of the Act authorizes States to use intermediate sanctions if an MCO fails substantially to provide medically necessary items and services that are required (under law or under the organization's contract with the State) to be provided to an enrollee covered under the contract. HCFA may also impose sanctions under 1903(m)(5)(A) of the Act if the failure to cover emergency services as required under 1932(b)(2) of the Act adversely affects (or has a substantial likelihood of adversely affecting) a Medicaid beneficiary. Contract termination may also be imposed for any violation of the requirements in sections 1903(m) and/or 1932 of the Act. http://cms.hhs.gov/states/letters/bba2208c.asp

Valid Places of Services

Emergency Behavioral Health Care, Crisis Intervention Services

POS code	Description
03	School
04	Homeless Shelter
05	Indian Health Service Free-Standing Facility
06	Indian Health Service Provider-Based Facility
07	Tribal 638 Free-Standing Facility
08	Tribal 638 Provider-Based Facility
11	Office
12	Home
15	Mobile Unit
20	Urgent Care Facility
21	Inpatient Hospital
22	Outpatient Hospital
23	Emergency Room — Hospital
24	Ambulatory Surgical Center
25	Birthing Center
31	Skilled Nursing Facility
32	Nursing Facility
33	Custodial Care Facility
34	Hospice
41	Ambulance — Land
42	Ambulance — Air or Water
50	Federally Qualified Health Center
51	Inpatient Psychiatric Facility
54	Intermediate Care Facility/Mentally Disabled
60	Mass Immunization Center
61	Comprehensive Inpatient Rehabilitation Facility
71	State or Local Public Health Clinic
72	Rural Health Clinic

Update of the Place of Service (POS) Code Set

Emergency Services Program