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Assertive Community Treatment (ACT)

Revised: 10-22-2013

Assertive Community Treatment (ACT) is an intensive, comprehensive, non-residential rehabilitative mental health service team model. Services are consistent with Adult Rehabilitative Mental Health Services ARMHS, except ACT services are:

  • • Provided by multidisciplinary, qualified staff who have the capacity to provide most mental health services necessary to meet the recipient’s needs, using a total team approach
  • • Directed to recipients with a serious mental illness who require intensive services
  • • Offered on a time-unlimited basis and are available to recipients 24 hours per day, 7 days per week, 365 days per year
  • The team promptly and appropriately responds to emergent needs and makes necessary staffing adjustments to assure the health and safety of recipients.

    Eligible ACT Providers

    An eligible ACT program must:

  • • Have a contract with a host county
  • • Be certified by DHS to provide ARMHS
  • • Meet specific fidelity standards, as detailed in the Minnesota Assertive Community (ACT) Standards
  • An ACT team includes the following specialists:

  • • Psychiatrist (or provisionally, a psychiatric NP or CNS-MH)
  • • Mental health professional, with supervisory experience, acting as team lead
  • • Registered nurse (RN), for medication management
  • • Mental health practitioners or rehab workers, including a:
  • • Substance abuse specialist, with at least one year of training or supervised experience in substance abuse treatment
  • • Vocational specialist, with at least one year training and experience in vocational rehabilitation and supported employment
  • Eligible Recipients

    Recipients eligible to receive ACT services must:

  • • Be eligible for MA
  • • Be adults (age 18 years or older)
  • • Have a primary diagnosis of serious mental illness as determined by a Diagnostic Assessment
  • • Be a member of the target population the ACT team serves
  • • Have a LOCUS assessment with a Level 4 indication
  • • Have a completed Functional Assessment following the domains specified by statute with three or more areas of significant impairment in functioning.
  • Covered ACT Services

    The ACT team provides the following services:

  • • Case management that supports the recipient’s access to services, such as:
  • • Medical and dental services
  • • Social services
  • • Transportation
  • • Legal advocacy
  • • Support and skills training in:
  • • Activities of daily living (self-care, home-making, financial management, use of transportation and health and social services)
  • • Social and interpersonal relationships
  • • Leisure time activities (including social, recreational and educational activities)
  • • Illness education and medication management
  • • Assistance in locating and maintaining safe, affordable housing, with an emphasis on recipient choice and independent community housing
  • • Psycho-education to family members
  • • Discharge:
  • • Supports are reduced as the recipient demonstrates increasing independence
  • • Recipients have easy access to the ACT team after graduating
  • • Recipients can return to the ACT team, if needed
  • Billing

    MHCP reimburses ACT services:

  • • Based on one, all-inclusive daily rate
  • • To one provider per day
  • Each claim must be for a face-to-face contact (ACT team member and recipient).

    Only one agency may bill when team members are from more than one agency. The billing provider reimburses other contributing agencies.

    Bill ACT program services to MHCP using MN–ITS 837P:

  • • Use procedure code H0040
  • • Enter one date of service per line
  • • Enter place of service (POS) code 21 if ACT services were provided to a recipient in an inpatient hospital
  • • Do not enter a treating provider
  • If MHCP denies your ACT services claim because ARMHS or Day Treatment claims were paid without authorization, contact the MHCP Provider Call Center to request a reversal of the ARMHS or Day Treatment claim. After the reversal, resubmit your ACT claim.

    ACT & Other Concurrent Services
    The ACT team must coordinate all services provided concurrently with ACT services

    When requesting authorization, clearly document medical necessity for the additional service(s), including reasons ACT does not/cannot meet recipient’s needs (e.g., specialty service, transitional service, etc.)

    Other Service

    Is service included in ACT?

    Can service be provided in addition to ACT?

    Service Limitations

    MH-TCM

    Yes

    No

    Case management functions are bundled in the ACT rate.
    MH-TCM is covered only in the month of admission or discharge from ACT. MH-TCM must request authorization for coverage other than month of admission/discharge.

    Day Treatment

    No

    Yes

    Day Treatment program must request authorization.
    If ACT team approves Day Treatment, ACT team must provide a statement to Day Treatment provider for authorization request purposes.

    Partial Hospitalization

    No

    Yes

    Partial hospitalization thresholds and limitations apply.

    IRTS

    No

    Yes

    ACT and IRTS may be provided concurrently without authorization.

    ARMHS

    Yes

    Yes

    ARMHS provider must request authorization.
    If ACT team approves ARMHS, ACT team must provide a statement to ARMHS provider for authorization request purposes.

    Crisis Assessment and Intervention (mobile)

    Usually

    If separately contracted

    A component of ACT.
    Cannot be billed separately.
    No authorization required.

    Crisis Stabilization – Non-residential

    Yes

    No

    A component of ACT.
    Cannot be billed separately.
    No authorization required.

    Crisis Stabilization – Residential

    No

    Yes

    Service limits apply.
    Services must be coordinated between the ACT and residential crisis providers.

    Psychiatric Physician Services

    Sometimes

    Yes

    May be provided by physician, psychiatric NP, CNS-MH, or a physician extender (e.g., RN).
    Bill separately only if not included in ACT rate.

    Outpatient Psychotherapy

    Sometimes

    Yes

    Outpatient psychotherapy limits apply.
    May bill separately if not provided by ACT team.

    Inpatient Hospitalization

    No

    Yes

    Inpatient hospitalization services are reimbursed separately from ACT.
    ACT claims: enter POS code 21.

    Waivered Services

    No

    Yes

    County must approve concurrent care.

    Other medical services (e.g., PCA)

    No

    Yes

    Service limits apply to each service.


    Legal References

    MS 256B.0623: ARMHS

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