1. (1) The program must authorize the following mental health services and/or treatment:

   1. (a) Consultations beyond what are allowed in WAC 296-31-065;
   2. (b) Inpatient hospitalization;
   3. (c) Concurrent treatment with more than one provider;
   4. (d) Electroconvulsive therapy;
   5. (e) Neuropsychological evaluation (testing);
   6. (f) Day treatment for seriously ill children under eighteen years old;
   7. (g) Referrals for services or treatment not in our fee schedule;
   8. (h) Teleconsultations and other telehealth services.

2. (2) Your request for authorization must be in writing and include:

   1. (a) A statement of the condition(s) diagnosed;
   2. (b) Current DSM or ICD codes;
   3. (c) The relationship of the condition(s) diagnosed to the criminal act; and
   4. (d) An outline of the proposed treatment program that includes its length, components, procedure codes and expected prognosis.

[Statutory Authority: Chapter 7.68 RCW. WSR 12-23-085, § 296-31-016, filed 11/20/12, effective 1/1/13. Statutory Authority: RCW 7.68.030 and 51.04.030. WSR 99-20-031, § 296-31-016, filed 9/29/99, effective 11/1/99.]