405 IAC 5-21.6-11 Therapy and behavioral support services

Sec. 11. (a) The services reimbursable as therapy and behavioral support services include the following: (1) Services provided in an individual or a group setting. (2) Services provided to family members or other nonprofessional caregivers in an individual or group setting, with or without the member present. (b) Services provided to a member must be: (1) time-limited; (2) structured; and (3) provided in a face-to-face session. (c) Services provided must meet the following requirements: (1) Be provided either at home or at locations outside the clinic setting. (2) Be provided in an individual setting or a group setting. (3) Be a face-to-face interaction with the member, family members, or nonprofessional caregivers supporting a member. (4) The member must be the focus of the service. (d) Provider staff delivering services under this subsection must meet one (1) of the following qualifications: (1) Be a licensed professional, as defined in this rule, except not a licensed clinical addiction counselor as defined under IC 25-23.6-10.5. (2) Be a QBHP. (e) Therapy and behavioral support service standards include the following: (1) Observation of the member and environment for purposes of the development of the IICP. (2) Development of a person-centered behavioral support plan and subsequent revisions that may be a part of the IICP. (3) Therapy and support activities include, but are not limited to, the following: (A) Assertiveness training. (B) Stress reduction techniques. (C) Development of socially accepted behaviors. (D) Implementation of a behavior support plan for staff, family members, roommates, and other appropriate individuals. (f) The services are not reimbursable under this section if provided in a clinic setting.