General Definitions

As used in 101 CMR 329.00, unless the context requires otherwise, terms have the meanings in 101 CMR 329.02. Case Consultation. Intervention, including scheduled audio-only telephonic, audio-video, or in- person meetings, for behavioral and medical management purposes on an individual’s behalf with agencies, employers, or institutions, which may include the preparation of reports of the individual’s psychiatric status, history, treatment, or progress (other than for legal purposes) for other physicians, agencies, or insurance carriers. Child and Adolescent Needs and Strengths (CANS). A tool that provides a standardized way to organize information gathered during behavioral-health clinical assessments. A Massachusetts version of the tool has been developed and is intended to be used as a treatment decision support tool for behavioral-health providers serving MassHealth members younger than 21 years old. Couple Therapy. Psychotherapeutic services provided to a couple whose primary complaint is the disruption of their marriage, family, or relationship. Developmental Assessment. The assessment of developmental status including the administration of developmental testing to assess fine and/or gross motor, language, cognitive level, social, memory, and/or executive functions. Developmental Testing. The assessment of fine and/or gross motor, language, cognitive level, social, memory, and/or executive functions by standardized developmental instruments, which may include the interpretation and reporting of results. Diagnostic Services Evaluation. The examination by interview techniques and determination of a patient's physical, psychological, social, economic, educational, and vocational capabilities and disabilities for purposes of developing a diagnostic formulation and designing a treatment plan. Eligible Provider. Any psychologist, licensed independent behavioral health clinician, or technician for test administration who meets the conditions of participation that have been or may be adopted by a governmental unit purchasing psychological and licensed independent behavioral health clinician services. EOHHS. The Executive Office of Health and Human Services established under M.G.L. c. 6A. Family Consultation. A scheduled meeting of at least one-half hour with one or more of the parents, legal guardian, or foster parents of a child who is being treated by the provider, when the parents, legal guardian, or foster parents are not clients of the provider. Family Therapy. The psychotherapeutic treatment of more than one member of a family simultaneously in the same session. Governmental Unit. The Commonwealth, any department, agency, board or commission of the Commonwealth and any political subdivision of the Commonwealth. Governmental units include public school departments. Group Therapy. The application of psychotherapeutic or counseling techniques to a group of persons, most of whom are not related by blood, marriage, or legal guardianship. Individual Consideration (IC). Those rates for psychological and licensed independent behavioral health clinician services for which no total allowable fee is specified in 101 CMR 329.00 and which are determined by a governmental unit based on the nature, extent, and need for such service and the degree of skill and time required for its provision. Providers must maintain adequate records to determine the appropriateness of their IC claims and must provide these documents to the purchasing agency upon demand. Individual Therapy. Psychotherapeutic services provided to an individual. Intelligence Assessment. A battery of tests to measure intelligence and cognitive ability, listed in the Mental Measurement Yearbook, or that conforms to the Standards for Educational and Psychological Tests of the American Psychological Association, such as a full Wechsler Adult Intelligence Scale, Wechsler Intelligence Scale for Children, or Stanford-Binet Intelligence Scales. Licensed Independent Behavioral Health Clinician. A licensed independent clinical social worker (LICSW), licensed mental health counselor (LMHC), or licensed marriage and family therapist (LMFT) who meets the requirements of 130 CMR 462.404: Provider Eligibility. Multiple-family Group Therapy. The treatment of more than one family unit, at the same time in the same visit, by one or more authorized staff member. In this type of therapy, there must be more than one family member present per family unit and at least one of the family members per family unit must be an identified patient of the center. Neuropsychological Assessment. A battery of performance-based assessments provided by an eligible provider that assesses cognitive functioning and developmental delays, in order to examine the cognitive consequences of brain damage, brain disease, physical, and mental illness, and other conditions that may impact cognitive functioning and achievement of developmental milestones. A neuropsychological or developmental assessment may include tests of intelligence, attention and concentration, learning and memory, processing speed, visual spatial perception, language skills, visual motor and fine motor skills, sensory perception, executive functioning and emotional functioning. Developmental assessments must rely on standardized developmental instruments when performed, and they may include assessment of gross motor skills. Personality Assessment. A battery of techniques that yield an evaluation of personality, using at least two personality tests that are listed in the Mental Measurement Yearbook, or that conform to the Standards for Educational and Psychological Tests of the American Psychological Association, unless clinically contraindicated. Psychological Assessment. The use of standardized test instruments and procedures to evaluate aspects of an individual's functioning. Psychological assessment includes intelligence, neuropsychological and developmental, and personality assessment. Testing items used for psychological assessment must be published, valid, and in general use as defined by listing in the current Mental Measurement Yearbook, or by conformity to the Standards for Educational and Psychological Tests of the American Psychological Association. Psychotherapy. The utilization of psychological and interpersonal theories and related practice methodologies to assess, interpret, and modify conscious and unconscious processes of behavior. Publicly Aided Individual. A person for whose medical and other services a governmental unit is in whole or in part liable under a statutory program. Telehealth. The use of synchronous or asynchronous audio, video, electronic media or other telecommunications technology, including, but not limited to: (a) interactive audio-video technology; (b) remote patient monitoring devices; (c) audio-only telephone; and (d) online adaptive interviews, for the purpose of evaluating, diagnosing, consulting, prescribing, treating or monitoring of a patient's physical health, oral health, mental health or substance use disorder condition. Treatment Service. A service related to diminishing the distress and symptoms of mental health or substance use disorder, as defined by the current edition of the Diagnostic and Statistical Manual of Mental Disorders including, but not limited to, individual, couple, family, and group psychotherapy. The use of evidence-based treatment modalities is encouraged.