ARM 37.79.316. MENTAL HEALTH BENEFITS

(1) Mental health benefits include: (a) inpatient services furnished by public or private licensed and qualified practitioners in a hospital, including a state-operated mental hospital, a residential service, or a partial hospitalization program; and (b) outpatient services furnished by public or private licensed and qualified practitioners in a community based setting or in a mental hospital. (2) Mental health benefits are limited to: (a) 21 days of inpatient mental health care per benefit year; (b) partial hospitalization benefits which are exchanged for inpatient days at a rate of two partial treatment days for one inpatient day; and (c) 20 outpatient visits per year which can be furnished in community based settings or in a mental hospital. (3) Mental health benefits will not be limited for enrollees with the following disorders: (a) schizophrenia; (b) schizoaffective disorder; (c) bipolar disorder; (d) major depression; (e) panic disorder; (f) obsessive-compulsive disorder; and (g) autism. (4) Additional mental health benefits are available for children with a serious emotional disturbance. These additional services are limited and may include: (a) additional therapeutic group home care, including room and board; (b) additional office visits for enrollee and/or family; (c) therapeutic family care (moderate level); (d) day treatment; (e) community based psychiatric rehabilitation and support; and (f) respite care. (5) Mental health benefits shall be provided at least to the extent required by state law.