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Massachusetts Behavioral Health Services Policy Manual

Massachusetts Behavioral Health Services Policy Manual

$4,199.00Price
ABOUT THIS POLICY MANUAL
 
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The Massachusetts Behavioral Health Services Policy Manual provides a comprehensive framework for operating state-compliant agencies delivering behavioral health services to individuals in Massachusetts. This manual aligns with the Massachusetts Code of Regulations (130 CMR 429.000 and 104 CMR 27.00), Department of Mental Health (DMH) licensing standards, and MassHealth requirements to ensure full regulatory compliance and high-quality care delivery.
Key Features of the Manual:
  • Regulatory Compliance: The manual adheres to state-specific regulations, including 130 CMR (Mental Health Services) and DMH standards under 104 CMR (Licensure of Mental Health Facilities). It ensures providers meet all licensing, operational, and documentation requirements for behavioral health services.
  • Service Scope: Behavioral health services encompass a wide range of supports, including outpatient therapy, psychiatric care, substance use disorder treatment, crisis intervention, case management, and community-based mental health services. Specialized programs for children, adolescents, and adults are included to address diverse needs.
  • Eligibility Criteria: Services are available to individuals experiencing mental health conditions or substance use disorders requiring therapeutic intervention. 
  • Conditions of Payment: Payment for behavioral health services requires prior authorization from MassHealth or DMH. Providers must adhere to established billing procedures and ensure services align with the participant’s individualized treatment plan (ITP). Reimbursement may vary based on the type and intensity of services provided.
  • Operational Standards: Policies include staffing qualifications such as licensed clinicians (e.g., psychologists, social workers, psychiatrists), adherence to evidence-based treatment protocols, compliance with safety standards, and maintaining a therapeutic environment.
  • Nonpayable Services: The manual specifies exclusions such as non-clinical services that do not meet medical necessity criteria or duplicative care covered under other Medicaid programs. Services provided in institutional settings without proper authorization are also excluded.
  • Quality Assurance: Robust quality assurance measures, including regular assessments of clinical outcomes, participant satisfaction surveys, and adherence to person-centered treatment planning principles. 
 
This policy manual serves as a guide for agencies seeking licensure or certification to provide behavioral health services in Massachusetts. It supports the delivery of comprehensive mental health and substance use disorder care while ensuring adherence to the state's regulatory framework for long-term services and supports (LTSS) and community-based behavioral health programs.
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