Community Mental Health Center (CMHC)

A CMHC is an entity that provides partial hospitalization services under Part B of the Medicare Program. For a CMHC to be authorized to provide these services, it must:

  • Meet applicable licensing or certification requirements for CMHCs in the State where it is located; and
  • Provide:
    • Outpatient services including specialized outpatient services for children, the elderly, individuals who are chronically mentally ill, and residents of its mental health service area who have been discharged from inpatient treatment at a mental health facility;
    • Twenty-four-hour emergency care services that provide access to a clinician and appropriate disposition with follow-up documentation of the emergency in the patient's CMHC medical record;
    • Day treatment, or other partial hospitalization services, or psychosocial rehabilitation services that provide structured day programs with treatment plans that vary in intensity of services and frequency and duration of services based on the needs of the patient;
  • At least 40 percent of its services to individuals who are not eligible for benefits under Title XVIII of the Social Security Act; and
  • Screening for patients who are being considered for admission to a State mental health facility to determine the appropriateness of such admission by an entity that has the appropriate clinical personnel and authorization under State law to perform all steps in the clinical evaluation process, with the exception of those that must be provided by a 24-hour facility. A CMHC that operates in a State that by law precludes it from providing these services may provide for such services by contract with an approved organization or entity (as determined by the Secretary of the Department of Health and Human Services) that, among other things, meets applicable licensure or certification requirements for CMHCs in the State where it is located.

The following services are not covered under a PHP:

  • Services to hospital inpatients;
  • Meals, self-administered medications, and
  • transportation; and
  • Vocational training.
     

Last Updated May 07, 2018