Community Mental Health Center (CMHC) - JE Part A

On this page, view the below information.

• Billing for CMHC
• Application Requirements
• Application Time Frame

All information is found in CMS Internet Only Manual (IOM), Publication 100-08, Medicare Program Integrity Manual, Chapter 10, Section 4.1.1 and the CMS IOM, Publication 100-07, State Operations Manual, Chapter 2. A CMHC is a facility that provides mental health services.

Must perform "core services" to qualify. These are:

• Outpatient Services
  • This includes services for children, elderly, persons who are chronically mentally ill and those who have been discharged from a mental health facility for inpatient treatment
• 24-hour-a-day emergency psychiatric services
• Day Treatment or other Partial Hospitalization (PH) services, or Psychosocial Rehab services
• Screening for patients being considered for admission to State mental health facilities

Billing for CMHC

• For more information regarding billing, go to the billing portion of the website.

Application Requirements

• Only one location per application may be reported in Section 4
• Must have the following attachments
  • A CMHC must provide at least 40 percent of its items and services to individuals who are not eligible for benefits under title XVIII of the Social Security Act. The document must have the following criteria:
    • Must be on the letter head of an independent entity who has reviewed the CMHC's client care data
    • Appropriate official of the certifying entity must sign the document such persons may include accounting technician, Chief Executive Officer (CEO), officers, directors - of the accounting agency
      • Noridian sends this to the state agency
    • Must have the audit completed for 3 months prior to the enrollment for an initial enrollment - revalidation needs for each of the intervening 12-month periods between initial enrollment and revalidation
      • Noridian sends this to the state agency
• The MAC will order a site visit

Application Time Frame

Note:

1. Once Noridian has completed the reviewal of the application, a Recommendation for Approval Letter is sent to the State Agency and CMS. There is no set timeframe for their review.
2. Additional days after State and CMS approval Noridian will have additional days to finalize enrollment records.