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NC Department of Health and Human Services Division of Mental Health, Developmental Disabilities, and Substance Abuse Services
 

All DHHS info for health care providers

 

Service Definitions

Archived Service Definitions

Service Definitions describe the services that providers can be paid for in the state's public system of MD/DD/SA services. The definitions include descriptions of:

  • Required components
  • Provider requirements
  • Staffing requirements, including experience, training, education
  • Service types/settings
  • Program requirements
  • Utilization management
  • Entrance criteria
  • Continued stay criteria
  • Discharge criteria
  • Expected outcomes
  • Service exclusions

Some service definitions are new, some are staying the same, some may be revised and some may be eliminated.

Overall, though, it is important for providers to know that many services are being bundled together into service definitions. This means that anyone wanting to bill for providing a service definition has to be able to provide all the services in that definition or bundle. Individual professionals or paraprofessionals will need to work for or with an agency that can provide all the services described in a service definition.

State Funded Enhanced Mental Health and Substance Abuse Services (NCTracks formerly known as IPRS Funded Enhanced MH/DD/SA Services) (8/1/13)

For detailed information on coverage criteria and service requirements for other types of services, please refer to the following clinical coverage policies. All are linked from here.

  • 8B: Inpatient Behavioral Health Services
  • 8C: Outpatient Behavioral Health Services Provided by Direct-Enrolled Providers
  • 8D-1:  Psychiatric Residential Treatment Facilities for Children under the Age of 21
  • 8D-2:  Residential Treatment Services

Existing State Funded DMH/DD/SA Service Definitions (7/13)

New State Funded DMH/DD/SA Services

Other Resources

 

 

State of North Carolina Home Page