405 IAC 5-21.5-2 Reimbursement

Sec. 2. (a) The office will reimburse MRO services for members who meet specific diagnosis and level of need criteria under the approved DMHA assessment tool. The listing of diagnostic and level of need criteria approved for reimbursement shall be as follows: (1) Will be listed and published in a provider manual by the office. (2) May be updated by the office as needed. (b) Services are provided: (1) through a behavioral health service provider that is enrolled as a provider that offers a full continuum of care as defined under IC 12-7-2-40.6 [NOTE: IC 12-7-2 is repealed by P.L. 145-2026, SECTION 62, effective July 1, 2026.] and 440 IAC 9; these providers may subcontract for services as appropriate; and (2) by personnel who meet appropriate federal, state, and local regulations for their respective disciplines or are under the supervision or direction of a licensed professional or QBHP.