Community Mental Health Center (CMHC) - JE Part A
Community Mental Health Center (CMHC)
On this page, view the below information.
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
- 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:
- The MAC will order a site visit
PECOS application
- "Institutional Provider" (e.g., Hospital, Skilled Nursing Facility, Hospice, Home Health Agency)
- Complete questionnaire to ensure correct applications (CMS-855A and CMS 588-EFT) populate.
- Complete all form sections
- Attach all supporting documentation such as IRS documents
- List all directors, board members, and contracted or W-2 managing employee
- Visit the Application Fee webpage to access CMS link to pay application fee
- Submit completed CMS-588 EFT and voided check/bank letter. EIN required to be on application in Tax Identification Number (TIN) field
Application Time Frame
| Application Type | Processing Time |
|---|---|
| PECOS | On average, it can take 15 to 50 calendar days before application is sent to state and CMS for approval |
| Paper | On average, it can take 30 to 65 calendar days before application is sent to state and CMS for approval |
Note:
- 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.
- Additional days after State and CMS approval Noridian will have additional days to finalize enrollment records.
Last Updated Nov 15 , 2024
