9104.1 Each Medicaid beneficiary receiving ASARS treatment shall be assigned a Clinical Care Coordinator.9104.2 Clinical Care Coordinators shall participate in a beneficiary's interdisciplinary team meetings in order to identify opportunities to further develop or update the treatment plan. The interdisciplinary team shall meet the requirements set forth in 29 DCMR § 2334.4.9104.3 A unit of clinical care coordination service shall be one (1) fifteen (15) minute increment, pursuant to DHCF's billing criteria.9104.4 Clinical care coordination service shall be subject to limitations on scope, frequency, and duration. Beneficiaries who require services in excess of established limits shall require prior authorization from DHCF.9104.5 Limitations for clinical care coordination services, by level of care, per treatment episode are as follows:- (a) Level IV shall not exceed sixteen (16) units;

- (b) Level III shall not exceed sixty-four (64) units;

- (c) Level II shall not exceed ninety-six (96) units; and

- (d) Level I shall not exceed one hundred ninety-two (192) units. Beneficiaries at Level I and receiving long-term Medication Assisted Treatment shall be allowed an additional sixteen (16) units.9104.6 Beneficiaries entering ASARS treatment at Level IV shall have clinical care coordination services provided by either qualified physicians or psychologists.9104.7 Beneficiaries entering ASARS treatment at Level III shall have clinical care coordination services provided by qualified physicians, psychologists, licensed independent clinical social workers, or advanced practice registered nurse.9104.8 Beneficiaries entering ASARS treatment at Levels II and I shall have clinical care coordination services provided by any of the following qualified practitioners:

(a) Licensed Independent Clinical Social Worker;

(b) Advanced Practice Registered Nurse;

(c) Registered Nurse;

(d) Licensed Independent Social Worker;

(e) Licensed Professional Counselor; or

(f) Certified Addiction Counselor II.

9104.9 Clinical care coordinators, except physicians and psychologists, shall provide clinical care coordination services under the supervision of the following practitioners:

(a) Licensed Independent Clinical Social Worker;

(b) Advanced Practice Registered Nurse;

(c) Registered Nurse certified in chemical dependency;

(d) Supervisory Certified Addiction Counselor II as defined in 17 DCMR § 8715; or

(e) An individual with a Bachelor’s degree from an accredited college or university in social work, counseling, psychology, or a closely related field, and at least two (2) full years of experience.

SOURCE: Final Rulemaking published at 59 DCR 11144 (September 28, 2012).