Md. Code Regs. 10.09.81.34

Current through Register Vol. 51, No. 25, December 13, 2024

Section 10.09.81.34 - Covered Services - Behavior Consultation Services

A. Definition. "Unit of service" means an hour of service rendered by a qualified individual during a home visit to a participant, not including:

(1) The time spent on related activities before or after the home visit; or

(2) The time spent on supervisory or consultative services to the provider.

B. A provider may bill for the length of a home visit to a participant, upon completion of the services specified in §D of this regulation.

C. Behavior consultation services may be preauthorized by a participant's plan of care as necessary and appropriate when:

(1) A participant's behavior is:

(a) Disruptive;

(b) Potentially dangerous to the participant's or another person's health and functioning; or

(c) Placing the participant at risk of institutionalization due to health and safety concerns; and

(2) Advice is needed as to how to manage the disruptive behavior of a participant.

D. Behavior consultation services include a:

(1) Home visit by an individual qualified to render services to:

(a) Evaluate a participant's acute behavior change;

(b) Assess the situation;

(c) Determine the contributing factors; and

(d) Recommend interventions and treatments;

(2) Written report prepared for review by the case manager and the assisted living services provider or the participant's family, which assesses the situation and makes recommendations; and

(3) Verbal review of the report with the case manager and the assisted living services provider or the participant's family to discuss:

(a) The report's findings and recommendations; and

(b) A course of action, including any related needed medical interventions.

Md. Code Regs. 10.09.81.34