A psychiatric day treatment program must ensure the availability of a sufficient variety of

professional and special services to meet the needs of its member population. These services may be provided by the program itself or through referral to other agencies, as set forth in 130 CMR 417.414. Professional and special services that meet the needs of a psychiatric day treatment program that are all inclusive include: diagnostic, bio-psychosocial evaluation, self-care, case management; group therapy; skills building and other recovery-oriented services; psycho-education; crisis planning and management; individualized treatment and recovery planning; multidisciplinary treatment review team; and discharge and aftercare planning, including relapse prevention planning. Programs refer for psychiatric and nursing assessment as indicated.

417.413: Other Reimbursable Services

The MassHealth agency pays a psychiatric day treatment program for the following

services only when such services are not provided during a psychiatric day treatment program session:

1. (A) a preadmission evaluation visit of at least one hour that consists of a comprehensive evaluation to determine the need for psychiatric day treatment program services and to design a treatment plan; and
2. (B) a face-to-face individual or group session lasting at least one hour with the member’s family or other involved persons to interpret accumulated data and to advise them on how to assist the member.

Commonwealth of Massachusetts Subchapter Number and Title Page

MassHealth 4. Program Regulations

4-7

Provider Manual Series (130 CMR 417.000)

Transmittal Letter Date

Psychiatric Day Treatment Manual

PDT-21 01/25/19