5210.1 Assertive Community Treatment (“ACT”) services shall include:

1. (a) Completion of comprehensive and ongoing assessments and development and updating of a self-care-oriented Plan of Care (if a current and effective one does not already exist);
2. (b) Medication prescription, administration, and monitoring;
3. (c) Crisis assessment and intervention;
4. (d) Symptom assessment and management;
5. (e) Individual and group counseling/therapy;
6. (f) Substance use disorder treatment for consumers with a co-occurring substance use disorder;
7. (g) Psychosocial rehabilitation and skill development;
8. (h) Interpersonal social and interpersonal skill training;
9. (i) Education, support, and consultation to consumers’ families and/or their support system, which is directed exclusively to the well-being and benefit of the consumer;
10. (j) Addressing social determinants of health;
11. (k) Daily living skills counseling and acquisition; and
12. (l) Coordination of medical and psychosocial services.

5210.2 Assertive Community Treatment shall:

1. (a) Be billed in fifteen (15) minute units;
2. (b) Require prior authorization from DBH; and
3. (c) Be delivered in accordance with the requirements set forth in Chapter 34 of Title 22-A DCMR.

5210.3 While a consumer is enrolled in ACT:

1. (a) Counseling/Therapy, Rehabilitation Day Services, IDT, CBI Levels 1, 2, 3, Public Welfare

and 4, TF-CBT, FFT, Trauma Recovery and Empowerment Services, and TST shall not be billed, unless otherwise authorized by DBH.

(b) Medication/Somatic Treatment and Community Support shall not be billed unless:

(1) Rendered by a provider that is different from the ACT provider, in the first thirty (30) calendar days of the consumer's enrollment into ACT or within thirty (30) calendar days prior to disenrollment from ACT; or

(2) The service is otherwise authorized by DBH.

(c) Crisis/Emergency Services shall not be billed, unless rendered by a provider that is different from the ACT provider, in the first thirty (30) calendar days of the consumer's enrollment into ACT or within thirty (30) calendar days prior to disenrollment from ACT.

5210.4 An ACT provider shall not bill Screening, Assessment, and Diagnosis services, unless the result of the ACT provider's assessment is a determination that ACT services are not indicated for the consumer.

SOURCE: Final Rulemaking published at 49 DCR 4860 (May 24, 2002); as amended by Final Rulemaking published at 69 DCR 012836 (October 21, 2022).