3419 MEDICATION/SOMATIC TREATMENT

3419.1 Medication/Somatic Treatment services are medical services and interventions, including physical examinations; prescription, supervision, or administration of mental-health related medications; monitoring and interpreting results of laboratory diagnostic procedures related to mental health-related medications; and medical interventions needed for effective mental health treatment provided as either an individual or group intervention.

3419.2 Medication/Somatic Treatment services include monitoring the side effects and interactions of a consumer's medications and the adverse reactions which a consumer may experience and providing restorative information and direction for symptom and medication self-management.

3419.3 Group Medication/Somatic Treatment services shall be therapeutic, educational, and interactive with a strong emphasis on group member selection. These services shall facilitate therapeutic peer interaction and support as specified in the Plan of Care.

3419.4 Each Medication/Somatic Treatment provider shall offer:

(a) A comprehensive psycho-educational program for consumers and families, as appropriate, regarding the consumer's mental illness, emotional disturbance, or behavior disorder; treatment and recovery goals; potential benefits and risk of treatment; and self-monitoring aids; and

(b) Consumer/family groups for restorative information, support, and enhancement of the therapeutic alliance between the consumer and the MHRS provider.

3419.5 Consumers receiving Medication/Somatic Treatment shall participate in a psychoeducational session to discuss medication side effects, adverse reactions to medications, and medication self-monitoring and management.

3419.6 Medication/Somatic Treatment shall be provided with no annual limits on services.

3419.7 Medication/Somatic Treatment shall not be billed on the same day as:

(a) ACT; or

(b) IDT.

3419.8 Medication/Somatic Treatment shall be provided:

(a) At the MHRS provider's service site;

(b) By telemedicine pursuant to 29 DCMR § 910;

(c) In natural settings, including the consumer's home or community setting; or

(d) A residential facility of sixteen (16) beds or less unless otherwise stated by the Department.

3419.9 The following are qualified practitioners of Medication/Somatic Treatment:

(a) Psychiatrists; and

(b) Advanced Practice Registered Nurses (APRNs).

3419.10 The following may deliver evaluation and management service under the direction of a Qualified Practitioner pursuant to § 3419.9:

(a) Physician Assistants (PAs).

(b) Registered Nurses (RNs); or

(c) Licensed Practical Nurses (LPNs).

SOURCE: Final Rulemaking published at 48 DCR 10297 (November 9, 2001); as amended by Final Rulemaking published at 51 DCR 9308 (October 1, 2004); as amended by Final Rulemaking published at 52 DCR 5682 (June 17, 2005); as amended by Final Rulemaking published at 67 DCR 10674 (September 4, 2020); as amended by Final Rulemaking 68 DCR 012400 (November 26, 2021); as amended by Final Rulemaking published at 70 DCR 003050 (March 10, 2023); as corrected by Errata Notice published at 71 DCR 004474 (April 19, 2024); as amended by Final Rulemaking published at 72 DCR 008497 (August 1, 2025).