Skip To: Main content|Subnavigation|
Minnesota Department of Human Services Provider Manual
DHS Home CountyLink Home Manuals Home Bulletins
Advanced Search
Show/Hide Table of Contents  

Adult Day Treatment

Revised: 05-17-2017

  • Overview
  • Eligible Adult Day Treatment Providers
  • Clinical Supervision
  • Eligible Recipients
  • Covered Day Treatment Services
  • Noncovered Services
  • Authorization
  • Authorization for Targeted Clinical Services Programs
  • Billing
  • Legal References
  • Overview

    Day treatment, day treatment services or day treatment program means a structured program of treatment and care provided to an adult in or by:

  • • A hospital accredited by the joint commission on accreditation of health organizations (JCAHO) and licensed under Minnesota Statutes, sections 144.50 to 144.55
  • • A community mental health center as defined under Minnesota Statutes, section 245.62
  • • An entity that is under contract with the county board to operate a program that meets the requirements of Minnesota Statutes, section 245.4712, subdivision 2, and Minnesota Rules, parts 9505.0170 to 9505.0475
  • Eligible Adult Day Treatment Providers

    The following agencies may apply to become day treatment providers:

  • • Licensed outpatient hospitals with JCAHO accreditation
  • • Community mental health centers enrolled with Minnesota Health Care Programs (MHCP)
  • • Entities under contract with a county to operate a day treatment program
  • Individual members of the adult day treatment multidisciplinary team must meet, at a minimum, the standards for a mental health practitioner. Psychotherapy components of day treatment must be provided by a mental health professional or a mental health practitioner qualified as a clinical trainee.

    Follow group psychotherapy guidelines for staffing and group size requirements.

    If providing children’s day treatment to recipients 18-20 years old, providers must also be CTSS-certified.

    Clinical Supervision

    Adult day treatment providers are required to follow Clinical Supervision of Outpatient Mental Health Services (Rule 47) guidelines.

    Eligible Recipients

    Eligible recipients of adult day treatment must:

  • • Be eligible for MHCP
  • • Be 18 years old or older (recipients age 18-20 years may receive adult day treatment, CTSS or both, depending on medical necessity)
  • • Meet all criteria for admission or continuing stay, as listed below
  • Recipients enrolled in a managed care organization (MCO) must receive day treatment services through the MCO, which may have different coverage and authorization requirements.

    Admission Criteria
    For admission, a recipient must:

  • • Have a primary diagnosis of mental illness as determined by a diagnostic assessment (DA), excluding dementia and other organic conditions
  • • The DA must be completed following a face-to-face evaluation of an individual’s nature, severity and impact of behavioral difficulties, functional impairment, subjective distress, strengths and resources
  • • Have three or more areas of significant impairment in functioning as determined by a functional assessment (FA)
  • • An FA must also be completed prior to receiving services and no sooner than 30 days prior
  • • An FA is valid for 180 days
  • • Update the FA when the person undergoes any significant changes in functioning, life situation or status in any domain or life area
  • • A significant change in functioning calls for a reassessment of the functional domains, regardless of the due date for updating the functional assessment
  • • Have a completed LOCUS assessment with a Level 3 indication
  • • A LOCUS must also be completed prior to receiving services and no sooner than 30 days prior
  • • A LOCUS is valid for 180 days
  • • Update a LOCUS when a person undergoes any significant change in functioning, a significant life event has occurred or within ten days prior to discharge. These changes call for a new LOCUS assessment
  • • Be experiencing symptoms impairing thought, mood, behavior or perception that interfere with the ability to function with a lesser level of service
  • • Have the cognitive capacity to engage in and benefit from this level of treatment
  • • Reasonably be expected to benefit in improved functioning at work, school or social relationships
  • • Need a highly structured, focused treatment approach to accomplish improvement and to avoid relapse requiring higher level of treatment
  • Day treatment may also be appropriate for:

  • • Recipients with a brain injury (BI) diagnosis that coexists with the primary mental illness diagnosis
  • • Court ordered treatment or for a recipient who is a potential danger to self, if the program provides adequate structure and sufficient support systems exist in the community
  • • Recipients residing in inpatient or residential facilities (nursing facilities, IMDs, hospitals, RTC) when an active discharge plan indicates a move to an independent living arrangement within 180 days. A mental health professional must deem the day treatment services medically necessary and the facility plan of care must include day treatment
  • Continuing Stay Criteria
    For a recipient to continue treatment, the following criteria must be met:

  • • The recipient’s condition continues to meet admission criteria as evidenced by active psychiatric symptoms and continued functional impairment
  • • The treatment plan contains specific goals and documented measurable progress toward goals
  • • An active discharge plan is in place
  • • Attempts to coordinate care and transition to other services are documented, as clinically indicated
  • Include interventions provided and the recipient’s response in the recipient’s daily record.

    Discharge Criteria
    Discharge a recipient who meets any of the following:

  • • Treatment plan goals and objectives have been met
  • • No longer meets continuing stay criteria
  • • Mental health disorder(s) has decreased and lesser level of service is appropriate
  • • Is voluntarily involved in treatment and no longer agrees to attend day treatment
  • • Exhibits severe exacerbation of symptoms or disruptive or dangerous behaviors requiring more intensive level of service. Do not close chart if individual is expected to return to day treatment
  • • Does not participate despite multiple attempts to engage the person and address nonparticipation issues
  • • Does not make progress toward treatment goals and no reasonable expectation that progress will be made
  • • No longer meets the criteria for a LOCUS Level 3
  • • Does not have or ceases to have the cognitive capacity to benefit from day treatment services. Refer recipient to the county human service or private agency for other services, such as:
  • • Day habilitation programs
  • • Adult day care
  • • Waiver program services
  • Covered Day Treatment Services

    Adult day treatment consists of:

  • • At least one hour of group psychotherapy (maximum of two hours)
  • • Group time focused on rehabilitative interventions, or other intensive therapeutic services, provided by a multidisciplinary staff
  • • A group of at least three, but not more than 12. For a group of three to eight persons, one mental health professional or practitioner is required to conduct the group. For a group of nine to 12 persons, a team of at least two mental health professionals or two mental health practitioners or one mental health professional and one mental health practitioner is required to co-conduct the group.
  • The services must:

  • • Stabilize the recipient's mental health status
  • • Develop and improve the recipient’s independent living and socialization skills
  • • Be included in the recipient's individual treatment plan (ITP). The ITP must:
  • • Be completed before the completion of five working days in which service is provided or within 30 days after the diagnostic assessment is completed or obtained, whichever occurs first
  • • Include attainable, measurable goals as they relate to day treatment services
  • • Be reviewed by the provider and updated with recipient progress at least every 90 days until discharge, and include an available discharge plan
  • • Document the interventions provided and the client's response on a daily basis
  • • Include an attainable discharge plan for the recipient
  • • Must be a collaborative and person-centered process involving the recipient, and with the permission of the recipient, the recipient's family and others in the recipient's support system
  • • The ITP and subsequent revisions of the ITP must be signed by the client before treatment begins. The mental health professional or practitioner will request the client, or other person authorized by statute to consent to mental health services for the client, to sign the client's ITP or revision of the ITP
  • • If the client or authorized person refuses to sign the plan or a revision of the plan, the mental health professional or mental health practitioner will note on the plan the refusal to sign and the reason(s) for the refusal
  • Noncovered Services

    The following services or activities may not be billed as day treatment:

  • • Services provided to recipients residing in an inpatient or residential facility (except when following the discharge plan guidelines, listed under Admission Criteria)
  • • Primarily recreation-oriented, non-medically supervised services or activities, including, but not limited to:
  • • Sports activities
  • • Exercise groups
  • • Craft hours
  • • Leisure time
  • • Social hours
  • • Meal or snack time or preparation
  • • Trips to community activities
  • • Tours
  • • Social or educational services that do not have or cannot reasonably be expected to have therapeutic outcomes related to the recipient’s mental health condition
  • • Consultations with other providers or service agency staff about the care or progress of a recipient
  • • Prevention or education programs provided to the community
  • • Day treatment for recipients with a primary diagnosis of alcohol or other drug abuse
  • • Day treatment provided in the recipient’s home
  • • Psychotherapy for more than two hours daily
  • • Participation in meal preparation and eating that is not part of a clinical treatment plan to address a recipient’s eating disorder
  • • Services not included in the recipient’s treatment plan as medically necessary and appropriate
  • • Less intensive services, such as a “club-house” or social program not covered by MHCP
  • Authorization

    Refer to Authorization for general authorization policy and procedures. For adult day treatment, authorization is required to:

  • • Exceed 115 hours of day treatment per calendar year
  • • Provide adult day treatment services concurrent with other services
  • To request authorization, submit the following:

  • MHCP Authorization Form (DHS-4695) (PDF) (except when using MN–ITS)
  • Adult Mental Health Rehabilitative Services Authorization Form (DHS-4159A) (PDF)
  • • Most current diagnostic assessment
  • • Current functional assessment
  • • Current individual treatment plan
  • • Discharge plan, if active
  • • Current interpretive summary
  • • LOCUS
  • Special Consideration for Concurrent Residential Crisis Stabilization
    The day treatment provider must submit a request for authorization, along with a letter of support from the residential crisis stabilization provider, if the recipient meets at least one of the following:

  • • Was already attending adult day treatment and continuation of these services adds appropriate continuity to his or her life
  • • Needs more intensive therapeutic intervention than the crisis stabilization facility can provide
  • • Needs specific therapeutic intervention that the crisis stabilization program cannot provide (treatment for eating disorders, obsessive or compulsive disorder, etc.)
  • • Is transitioning to day treatment following the stay at the crisis stabilization facility
  • Authorization for Targeted Clinical Services Programs

    Follow all threshold and authorization requirements for adult day treatment. For targeted clinical services, the following additional documentation requirements also apply:

    • Complete a diagnostic assessment annually

  • • Complete a functional assessment and LOCUS every 180 days
  • • The recipient’s treatment plan, including:
  • • Treatment guidance for a six month time period
  • • Monthly reviews and updates on goals and objectives
  • • Progress notes for the previous two weeks. For recipients who progress more slowly, a quarterly report may be used to emphasize progress
  • • Optional, additional assessments of:
  • • Cognitive functioning
  • • Risk of re-offense
  • Billing

  • • Bill day treatment services online using MN–ITS 837P
  • • Do not use a modifier
  • • Do not provide or bill for adult day treatment for children under 18 years old
  • Adult Day Treatment






    Behavioral Health Day Treatment

    1 hour

    Maximum 15 hours per week - may not obtain authorization for more day treatment hours in a week

    115 hours per calendar year without authorization

    Legal References

    Minnesota Rules 9505.0370 to 9505.0372 MA Outpatient Mental Health Services
    Minnesota Rules 9520.0750 to 9520.0870
    Mental health center/clinic standards (Rule 29)
    Minnesota Rules 9520.0800
    Minimum quality assurance standards (Rule 29)
    MN Statutes 245.62
    Establishing a mental health center
    MN Statutes 245.467 Quality of services, Subd. 3
    Individual treatment plans

    Rate/Report this pageReport/Rate this page

    © 2019 Minnesota Department of Human Services Updated: 12/29/17 8:59 AM | Accessibility | Terms/Policy | Contact DHS | Top of Page | Updated: 12/29/17 8:59 AM