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Minnesota Department of Human Services Provider Manual
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Family Psychoeducation

Date: 12-31-2015

  • Overview
  • Eligible Providers
  • Eligible Recipients
  • Covered Services
  • Authorization
  • Billing
  • Legal References
  • Overview

    Family psychoeducation services are planned, structured and face-to-face interventions that involve presenting or demonstrating information. The goal of family psychoeducation is to help prevent relapse or development of comorbid disorders and to achieve optimal mental health and long-term resilience. It supports the recipient and family in understanding these factors:

  • • The recipient’s symptoms of mental illness
  • • The impact on the recipient's development
  • • Needed components of treatment
  • • Skill development
  • In addition to the information in this section, refer to the Family Psychoeducation Frequently Asked Questions.

    Eligible Providers

    MHCP enrolled mental health professionals or their clinical trainee may provide family psychoeducation.

    The following mental health professionals may enroll with MHCP:

  • Clinical nurse specialist in mental health (CNS)
  • Licensed independent clinical social worker (LICSW)
  • Licensed marriage and family therapist (LMFT)
  • Licensed professional clinical counselor (LPCC)
  • Licensed psychologist (LP)
  • Psychiatric nurse practitioner (NP)
  • Psychiatrist
  • • Tribal certified professional
  • The following providers are not eligible to enroll as an MHCP provider:

  • • Mental health practitioners who qualify as clinical trainees
  • • Clinical supervisors
  • Providers must follow Clinical Supervision of Outpatient Mental Health Services (Rule 47) guidelines.

    Eligible Recipients

    Eligible recipients of family psychoeducation must have a diagnosis of emotional disturbance or mental illness as determined by a diagnostic assessment and be under age 21.

    Covered Services

    MHCP covers family psychoeducation services for any of the following in outpatient settings when directed toward meeting the identified treatment needs of each participating recipient as indicated in the recipient’s treatment plan:

  • • The recipient (individual)
  • • A recipient’s family (with or without the recipient present)
  • • Groups of recipients (peer group)
  • • Multiple families (family group)
  • If you believe the recipient’s absence from a family psychoeducation session is necessary, document the length of time and reason for the recipient to be absent. Family members or primary caregivers do not need to be eligible for MHCP to participate.

    These services may be provided via telemedicine. Refer to the Telemedicine Delivery of Mental Health Services section of the MHCP Provider Manual.

    Family

    The recipient’s family includes people the recipient, parent or guardian identify as being important to the recipient's mental health treatment. Family may include, but is not limited to the following:

  • • Parents or caregivers
  • • Siblings
  • • Children
  • • People related by blood or adoption
  • • People who are presently living together as a family unit
  • Do not consider shift staff or other facility staff members at the recipient’s residence as family members.

    Peer Group

    A peer group must be at least three, but no more than 12 recipients. The following criteria for groups applies:

  • • For groups of three to eight recipients, at least one mental health professional or clinical trainee must conduct the group.
  • • For groups of nine to 12 recipients, any combination of at least two mental health professionals or clinical trainees must co-conduct the group
  • Family Group

    The following criteria applies for family groups:

  • • A family group must be at least two but no more than five families.
  • • For groups of five to 10 families, any combination of at least two mental health professionals or clinical trainees must co-conduct the group
  • Documentation of Covered Services

    Refer to the following sections for documentation requirements.

    Medical Necessity

    Document the medical necessity for family psychoeducation in the diagnostic assessment. The diagnostic assessment must describe how the child meets criteria for a mental health condition. You may include this description in the initial assessment, in an addendum to the diagnostic assessment, or within the narrative portion of the individualized treatment plan (ITP) review process. Submit this information with any request for authorization.

    Individualized Treatment Plan

    Document in the ITP the specific interventions, describing how the mental health professionals will use family psychoeducation to treat the child’s mental illness.

    Progress Notes

    Progress notes must be legible and must include the following information, at a minimum:

  • • Type of service (recipient, family, peer group or family group)
  • • Date of service
  • • Session start and stop times
  • • Scope of service (nature of interventions)
  • • Number of attendees
  • • Role of attendees
  • • Attendees’ responses or reactions to the interventions
  • • Potential impact on eligible recipient
  • • Name(s) and title(s) of provider(s) who delivered the service
  • • Date documentation was made in the recipient’s record
  • For family psychoeducation performed by clinical trainees, the clinical supervisor must review and approve the recipient’s progress notes according to the clinical trainee’s supervision plan.

    Noncovered Services

    Family psychoeducation does not include the following:

  • • Communication between the treating mental health professional and a person under the clinical supervision of the treating mental health professional
  • • Written communication between providers
  • • Reporting, charting, and record keeping (These activities are the responsibility of the provider.)
  • • Mental health services not related to the recipient’s diagnosis or treatment for mental illness
  • • Communication provided while performing any of the following mental health services:
  • • Mental health case management
  • • In-reach services
  • • Youth ACT
  • • Intensive treatment services in foster care
  • Authorization Requirements

    Refer to the Authorization section for general authorization policy and procedures.

    Family psychoeducation units or sessions are subject to the same calendar year, cumulative limits as psychotherapy. These limits are as follows for family psychoeducation:

  • • 26 hours of individual psychoeducation per calendar year, cumulative
  • • 26 sessions of family psychoeducation per calendar year, cumulative
  • • 52 sessions of peer group psychoeducation per calendar year, cumulative
  • • 10 sessions of family group psychoeducation per calendar year, cumulative
  • • A maximum of 4 units of family psychoeducation, per individual in one day
  • • A maximum of 1 session (or 4 units) of family psychoeducation, per family in one day
  • • A maximum of 1 session (or 4 units) of family psychoeducation, per family in a multifamily group in one day
  • • A maximum of 1 session (or 4 units) of family psychoeducation, per individual in a group setting in one day
  • Follow the authorization process for psychotherapy services for continuation of services.

    Billing

    Submit claims only for the recipient who is the primary subject of the family psychoeducation sessions, regardless of the number of other family or group members in the session.

    When more than one family member is a recipient (such as two or three siblings, each receiving treatment within a specific timeframe), bill only for the time spent conducting family psychoeducation with each recipient.

    When two professionals render group family psychoeducation, submit only one claim for each recipient. Professionals must determine which recipient each will bill for or one professional may claim for all recipients and reimburse the other professional.

    When billing, use the following guidelines:

  • • Enter the treating provider NPI number on each claim line
  • • Use HN modifier for services performed by a clinical trainee
  • Use the following table for billing services:

    Family Psychoeducation Benefits for Children under aged 21

    Proc Code

    Modifier

    Brief Description

    Unit

    Service Limitation

    H2027

    Family Psychoeducation Individual (with a single recipient)

    15 min

    Calendar year threshold, see Authorization—104 units.

    Maximum 4 units/day.

    HQ

    Family Psychoeducation Recipient Group (with multiple recipients)

    Calendar year threshold, see Authorization—52 sessions.

    Maximum 1 session (6 units)/day.

    HR

    Family Psychoeducation Recipient and Family (with a single recipient and their family)

    Calendar year threshold, see Authorization—26 sessions.

    Maximum 1 session (6 units)/day.

    HS

    Family Psychoeducation Family (with a single family individual not present)

    Calendar year threshold, see Authorization—26 sessions.

    Maximum 1 session (6 units)/day.

    HQ HR

    Family Psychoeducation Family Group (with multiple families with individuals present)

    Calendar year threshold, see Authorization—10 sessions.

    Maximum 1 session (8 units)/day.

    HQ HS

    Family Psychoeducation Family Group (with multiple families individuals not present)

    Calendar year threshold, see Authorization—10 sessions.

    Maximum 1 session (8 units)/day.

    Legal References

    Minnesota Statutes, section 256B.0625, Subdv.61
    Minnesota Rules 9505.0370–9505.0372

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