53-21-1401. Definitions. As used in this part, the following definitions apply: (1) ”Adult” means an individual who is 18 years of age or older. (2) ”Crisis” means a serious, unexpected situation resulting from an individual’s apparent mental illness in which the individual’s symptoms are of sufficient severity, as determined by a mental health practitioner, to require immediate care […]
53-21-1402. Purpose — limitations. (1) (a) The purpose of this part is to establish a program through which enrolled providers may be reimbursed by the department when they provide mental health services during a 72-hour period to stabilize an adult who: (i) is in a mental health crisis; and (ii) is uninsured or whose insurance does not adequately cover […]
53-21-1403. Crisis stabilization services — requirements. (1) In order to qualify for reimbursement under this part, crisis stabilization services must be delivered in a safe environment to an individual in crisis as required under this section. (2) Crisis stabilization services must: (a) be delivered by an individual or facility that is enrolled with the department to provide services […]
53-21-1404. Claims and reimbursement — exceptions. (1) The department shall adopt and make available a fee schedule for crisis stabilization services. (2) Claims for crisis stabilization services provided pursuant to this part must be submitted to the department as provided by rule. (3) Providers shall accept the amounts payable under this section as payment in full for services […]
53-21-1405. Rulemaking authority. The department may adopt rules establishing: (1) limits on the scope and duration of crisis stabilization services, except for reimbursement for two psychiatric diagnostic interviews during the presumptive eligibility period; (2) requirements for participating providers and their enrollment in the program; (3) the scope of services that may be reimbursed because they involve coordination or management […]
