Wis. Admin. Code Department of Justice Jus 11.06 - Mental health treatment
(1) ELIGIBLE PROVIDERS. Eligible providers of
mental health treatment under this subchapter include a qualified treatment
trainee under clinical supervision as defined by s.
DHS 35.03(17m) or any of the following
individuals licensed by the state in which he or she practices:
(a) A physician who has completed a residency
in psychiatry.
(e) A
psychologist.
(f) A marriage and
family therapist.
(g) A
professional counselor.
(h) A
clinical social worker.
(2) ELIGIBLE SERVICES. Eligible types of
mental health treatment under this subchapter include:
(a) Inpatient psychiatric services provided
within the psychiatric unit of a general hospital or a psychiatric
facility.
(b) Outpatient
psychotherapy services.
(d)
Complementary mental health services may be considered for payment by the
department if administered in conjunction with any of the above-listed
treatments, prescribed by an eligible provider, and administered by an
accredited practitioner.
(3) LIMITATIONS ON ELIGIBLE SERVICES.
Limitations on eligible services include:
(a)
Collateral interviews are limited to the non-offending family
members.
(b) Group psychotherapy
sessions are limited to those in which not more than 10 individuals receive
psychotherapy services together from an eligible provider.
(c) Court appearances or evaluations are not
eligible services.
(4)
AUTHORIZATION PROCESS. The department shall require eligible providers of
services to submit an authorization request which may include the following
information:
(a) The name, address, and
medical assistance or identification number of the provider conducting the
diagnostic examination and performing the psychotherapy services.
(b) A detailed summary of the problems for
which the victim or claimant is seeking mental health treatment.
(c) A detailed summary of the diagnostic
examination, including the severity of the victim's or claimant's mental
illness, medically significant emotional or social dysfunctions, the medical
necessity for treatment and the suggested outcome of treatment.
(d) A statement of the estimated frequency of
treatment sessions and the estimated cost of treatment.
(e) A statement of the relationship between
the crime and the need for treatment, and to what extent the treatment is
directly related to the crime.
(f)
A statement of the victim's or claimant's psychological condition prior to the
crime.
(5) REVIEW
PROCESS.
(a) Department claims specialists
shall review authorization requests for mental health claims. The department
may appoint persons who meet the same minimum requirements that providers are
expected to meet to review authorization requests.
(b) The department shall review the progress
of the treatment periodically as the department determines it is reasonable to
do so. Progress reports shall describe the victim's current symptoms, problem
changes in symptoms since the last report, progress made toward each treatment
goal, a list of impediments to progress, and a plan to address
impediments.
Notes
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.
No prior version found.