Service Definitions

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Service Definitions describe the services that providers can be paid for in the state's public system of Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMHDDSAS).

State-Funded IPS for COVID-19 Crisis - 4/22/20

CTI Service Definition COVID-19 - 4/22/20

Transition Management Services COVID-19 - 4/22/20

2022 State-Funded Enhanced Mental Health and Substance Abuse Services 

State-Funded Mental Health and Substance Abuse Services 2022 - 8/1/22

Please note that the “substance abuse” language has not been changed in order to remain in compliance with General Statute.  Utilization of more acceptable, less stigmatizing language is supported and used wherever possible.

  • November 1, 2019: The State-Funded Enhanced MH/SA Services 2019 document revision removed the Community Support Team (CST) service definition from the document. Community Support Team is now a standalone service definition located below.
  • December 15, 2019: The State-Funded Enhanced MH/SA Services 2019 document, State-Funded ACT Service, State-Funded Facility-Based Crisis-Child and State-Funded Community Support Team were amended to include a statement that the Division of MH/DD/SAS will not reimburse for conversion therapy per Executive Order # 97.  Additionally, a statement providing guidance to providers utilizing the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0–5) manual was added to the State-Funded Enhanced MH/SA Services 2019 document and State-Funded Facility-Based Crisis-Child service definition.
  • November 1, 2021:  The State-Funded Enhanced Mental Health and Substance Abuse Services 2021 was amended to remove Diagnostic Assessment which is now a stand alone service definition policy, remove limit on billable units in a 24-hour period in MST and provide a clarification in the Outpatient Opioid treatment service definition policy.  The State-Funded FBC-Child service definition policy was amended to include telehealth language, increase number of days the service can be provided in a 12-month period and amend supervision requirements.  Additionally, the new standalone State-Funded Diagnostic Assessment service definition policy was published including telehealth clarification and ASAM language.
  • April 1, 2022:  The State-Funded Enhanced Mental Health and Substance Abuse Services 2022 document has several amendments, including but not limited to, the following: adding a Telehealth Services section (Section 3.1.1); updating the State-Funded Service Summary chart; replacing “face-to-face” with “in-person” language throughout the document; adding language regarding licensed and certified professionals in compliance with NCGA Session Law 2019-240 Senate Bill 537; revising length of stay in several service definition policies; and revising the Outpatient Opioid Treatment Payment Unit Section.  Please see Section 8 Policy Implementation for a detailed list of amendments.
  • May 15, 2022:  The State-Funded Facility-Based Crisis- Child service definition clinical policy was amended as follows: Subsection 5.3 a.: Added “or Licensed Practical Nurse under the supervision of a registered nurse” and Subsection 6.2 c. & b.1.: Removed “on-site”.
  • August 1, 2022:  The State-Funded Enhanced MH/SA Services 2022 document revision deleted the following from Section 8: Attachment D, Medically Supervised or ADATC Detoxification Crisis Stabilization Deleted “30” and replaced with “45” in the Service Exclusions section.  

2018-2019 State-Funded MH/DD/SAS Service Definitions

State-Funded DMHDDSAS Service Definitions 2003-2019 - 12/15/19

The Division of MH/DD/SAS Service Definitions package has been revised based on DSM-5, ASAM, NC TRACKS and APSM language and other technical changes.

Technical revisions to the document include the following:

  • DSM-IV to DSM-5 including "or any subsequent editions of this reference material" to be inclusive of future changes.
  • ASAM PPC-2-R to The ASAM Criteria language (e.g. ASAM changed from Roman numeral to numerical)
  • IPRS and Pioneer to NC TRACKS language.
  • Revised "substance abuse" language to better reflect DSM-5 language when possible. Changed substance abuse to substance use when it pertained to a disorder, diagnosis, symptom, condition, intervention, treatment, etc. The substance abuse language stayed in place if it pertained to a provider, professional, service, etc. due to licensure rules, general statutes, DMA SPA, etc.
  • Updated developmental disabilities language to IDD as appropriate.
  • Included the Supports Intensity Scale under Medical Necessity as appropriate.
  • Eliminated service definitions that have been end dated (e.g. assertive outreach, case support, case management, etc.) See Quick Reference Guide, Appendix A for more details.
  • Eliminated service definitions when the definition utilized for billing purposes are found in other service definition or policy documents (e.g. SAIOP is in the State-Funded Enhanced MH/SA Service Definition package and child residential services are in DMA Clinical
  • Coverage Policy 8-D-2)See Quick Reference Guide, Appendix A for more details.
  • The only clinically revised service definition in the package was Outpatient Services. DMH/DD/SAS currently follows the Division of Medical Assistance's 8C, Outpatient Behavioral Health Services Provided by Direct-Enrolled Providers for outpatient services provided by licensed (CPT codes) or associate level professionals (for H-Codes) with the exception of the "Incident to" criteria. However, DMH/DD/SAS also has a set of YP codes specifically for "Designated Non-Licensed Substance Abuse Counseling Professionals". As a result, the Outpatient Services (SA YP Codes) definition in this package is now specifically for the SA-specific YP codes.

Additionally, a Quick Reference Guide: Revisions to 2003 State Service Definitions Package is included at the end of the document in Addendum A. This guide serves as a reference tool to determine which services are still in the package, services that are no longer in the package and where they can be found and services that were eliminated due to end dating.  

  • December 15, 2019:  All state-funded services listed below were amended to include a statement that the Division of MH/DD/SAS will not reimburse for conversion therapy per Executive Order # 97. Additionally, a statement providing guidance to providers utilizing Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0–5) manual was added to the State-Funded DMHDDSAS Service Definitions 2003-2019 document, State-Funded Inpatient Behavioral Health & State-Funded Developmental Therapy service definitions. 
  • November 1, 2021:  Published the State-Funded Telehealth and Virtual Communications Services policy intended to provide definitions and overarching guidance related to the delivery of services via telehealth and virtual communications that are not otherwise included in a state-funded service definition specific policy.  Also, posted amended State-Funded Peer Support Service which includes updated telehealth and telephonic language. 
  • August 15, 2022:  The State-Funded Peer Support Services policy was revised to remove the following from Section 3.2.1 Letter b.: “the Level of Care criteria for Locus Level 1”.   

Additional State-Funded Service Definition Policies: