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6321

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6341

6342

CORE SERVICE: SUBSTANCE USE DISORDER COUNSELING/THERAPY

6342.1 SUD Counseling/Therapy shall include Individual, Family, and Group Therapy.

6342.2 Providers shall deliver SUD Counseling/Therapy in certified SUD treatment programs or community settings.

6342.3 The following practitioners may provide SUD Counseling/Therapy:

(a) Qualified Practitioners of SUD Counseling/Therapy are:

(1) Psychiatrist;

(2) Physicians;

(3) Psychologists;

(4) Advanced Practice Registered Nurses (APRNs);

(5) Licensed Independent Clinical Social Workers (LICSWs);

(6) Licensed Marriage and Family Therapists (LMFTs); and

(7) Licensed Professional Counselors (LPCs).

(b) The following may deliver SUD Counseling/Therapy under the supervision of a Qualified Practitioner:

(1) Psychology Associates;

(2) Certified Addiction Counselors (CACs) I and II;

(3) Licensed Graduate Social Workers (LGSWs);

(4) Licensed Graduate Professional Counselors (LGPCs); and

(5) Licensed Independent Social Workers (LISWs).

6342.4 Individual SUD Counseling/Therapy is a face-to-face service for symptom and behavior management, development, restoration, or enhancement of adaptive behaviors and skills, and enhancement or maintenance of daily living skills to facilitate long-term recovery.

6342.5 Individual SUD Counseling/Therapy addresses the specific issues identified in the Plan of Care. Individual counseling/therapy shall:

(a) Be documented in an encounter note; and

(b) Not be conducted within the same or overlapping time period as Medication Management.

6342.6 Group Counseling/Therapy includes Cognitive Behavioral Groups, Support Groups, and Interpersonal Process Groups. Cognitive Behavioral Groups have a trained facilitator utilizing a specific therapeutic model to alter thoughts and actions that lead to substance use. Support Groups uplift members and provide a forum to share pragmatic information about managing day to day life. Interpersonal Process Groups delve into major developmental issues that contribute to SUD or interfere with recovery.

6342.7 The following provisions apply to Group SUD Counseling:

(a) Group SUD Counseling/Therapy addresses the specific issues identified in the Plan of Care;

(b) The focus of the group SUD Counseling/Therapy session shall be driven by the participants;

(c) A maximum of fifteen (15) individuals may participate in a single group SUD counseling/therapy session; and

(d) Group SUD Counseling/Therapy shall not be billed during recreational activities.

6342.8 Family Counseling/Therapy is a planned, goal-oriented therapeutic interaction between a Qualified Practitioner and the client's family, with or without the client present. The aim of Family Counseling/Therapy is to improve the client's functioning with their family and to cultivate the awareness, skills, and supports to facilitate long-term recovery. Family Counseling/Therapy shall address specific issues identified in the client's Plan of Care. Providers delivering Family Counseling/Therapy shall:

(a) Document services using an encounter note. If the client is not present, providers shall note how the session benefited the client;

(b) Document the relationship of the participant(s) to the client in the encounter note; and

(c) Ensure Family Counseling/Therapy participants other than the client meet the definition of "family member" in § 6351.

SOURCE: Final Rulemaking published at 62 DCR 12056 (September 4, 2015); as amended by Final Rulemaking published at 67 DCR 011585 (October 9, 2020); as amended by Final Rulemaking 68 DCR 012400 (November 26, 2021); as amended by Final Rulemaking published at 72 DCR 008497 (August 1, 2025).