Ohio Admin. Code 5160-27-12 - Behavioral health crisis intervention provided by unlicensed practitioners

(A) For the purpose of medicaid reimbursement, behavioral health crisis intervention is a timely face to face intervention with medicaid recipients who are experiencing a life threatening or complex emergent situation related to mental illness or a substance use disorder.
(1) The goals of crisis intervention are to ease the crisis, re-establish safety and institute interventions to minimize psychological trauma.
(2) Activities may include but are not limited to: emergent care, assessment, immediate stabilization, de-escalation, counseling, care planning and resolution.
(B) In order to provide behavioral health crisis intervention, practitioners must meet the requirements in paragraph (A)(6) of rule 5160-27-01 of the Administrative Code.
(1) For the purposes of this rule, the following unlicensed practitioners are excluded: care management specialist and peer recovery supporter.

(2) Practitioners may only provide crisis intervention if they have previously met and provided services to the recipient.

(3) (2) Practitioners of crisis intervention shall have current certification in first aid and cardio-pulmonary resuscitation (CPR).
(C) Limitations: crisis intervention will not be reimbursed when a recipient is enrolled in assertive community treatment (ACT), intensive home based treatment (IHBT) or receiving services in a substance use disorder (SUD) residential treatment facility.
(D) Providers shall adhere to documentation requirements set forth in rules 5160-1-27 and 5160-8-05 of the Administrative Code.
(E) Crisis psychotherapy rendered by licensed practitioners is authorized in rule 5160-8-05 of the Administrative Code and as defined by the American medical association's current procedural terminology book.


Ohio Admin. Code 5160-27-12
Effective: 1/1/2021
Five Year Review (FYR) Dates: 1/1/2023
Promulgated Under: 119.03
Statutory Authority: 5162.02, 5162.05, 5164.02
Rule Amplifies: 5164.03, 5164.02
Prior Effective Dates: 01/01/2018, 06/12/2020 (Emer.)

State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.