Assertive Community Treatment (ACT)

Revised: September 4, 2025

· Overview

· Eligible Providers

· Eligible Members

· Covered Services

· Billing

· Legal References

Overview

Assertive community treatment (ACT) means intensive nonresidential treatment and rehabilitative mental health services provided according to the assertive community treatment model. Assertive community treatment provides a single, fixed point of responsibility for treatment, rehabilitation and support needs for clients. Services are offered 24 hours per day, seven days per week, in a community-based setting. ACT services are provided as a team-based model.

Eligible Providers

An ACT team must:

· Be certified by Minnesota Department of Human Services

· Be an enrolled Minnesota Health Care Programs (MHCP) provider

An ACT team is required to have all of the following:

· Team leader (mental health professional)

· Psychiatric care provider

· Registered or advanced practice registered nurse

· Co-occurring disorder specialist

· Vocational specialist

· Mental health certified peer specialist

· Program administrative assistant

Based on team size, additional ACT team treatment staff may include the following:

· Mental health professional

· Clinical trainee

· Certified rehabilitation specialist

· Mental health practitioner

· Mental health rehabilitation worker

Program size for an ACT team is classified as small, midsize, or large based on the composition of the team as defined in Minnesota Statutes, 256B.0622, subdivision 7b.

ACT teams must ensure ACT staff qualifications, scope of practice, training and treatment supervision meet the applicable standards of Minnesota Statutes, 245I, Mental Health Uniform Service Standards Act.

Eligible Members

Minnesota Health Care Programs (MHCP) members eligible to receive ACT services must meet the criteria as assessed by an ACT team:

· 18 years old or older

· Have a primary diagnosis of schizophrenia, schizoaffective disorder, major depressive disorder with psychotic features or other psychotic disorders or bipolar disorder

· Have a significant functional impairment demonstrated by at least one of the following:

· Consistently performing the range of routine tasks required for basic adult functioning in the community or persistent difficulty performing daily living tasks without significant support or assistance

· Maintaining employment at a self-sustaining level or significant difficulty carrying out the head-of-household responsibilities

· Maintaining a safe living situation

· Have a need for continuous high-intensity services as evidence by at least two of the following:

· Two or more psychiatric hospitalizations or residential crisis stabilization services in the previous 12 months

· Frequent utilization of mental health crisis services in the previous six months

· 30 or more consecutive days of psychiatric hospitalization in the previous 24 months

· Intractable, persistent, or prolonged severe psychiatric symptoms

· Coexisting mental health and substance use disorders lasting at least six months

· Recent history of involvement with the criminal justice system or demonstrated risk of future involvement

· Significant difficulty meeting basic survival needs

· Residing in standard housing, experiencing homelessness, or facing imminent risk of homelessness

· Significant impairment with social and interpersonal functioning

· Coexisting mental health and physical health disorders lasting at least six months

· Residing in an inpatient or supervised community residence but clinically assessed to be able to live in a more independent living situation if intensive services are provided

· Requiring a residential placement if more intensive services are not available

· Difficulty effectively using office-based outpatient services

· No indication that other available community-based services would be equally or more effective as evidenced by consistent and extensive efforts to treat the member

· Have the written opinion of a licensed mental health professional that the member has the need for mental health services that cannot be met with other available community-based services or is likely to experience a mental health crisis or require more restrictive setting if assertive community treatment is not provided.

Individuals who are 16 or 17 years old and transitioning to adult mental health services may be considered for ACT if the service is determined to best meet the member’s needs and the ACT provider receives approval by the commissioner.

Covered Services

ACT teams must offer and have the capacity to provide the following services:

· Assertive engagement

· Benefits and finance support

· Co-occurring disorder treatment as defined in Minnesota Statutes, 245I.02, subdivision 11

· Crisis assessment and intervention

· Employment services

· Family psychoeducation and support

· Housing access support

· Medication assistance and support

· Medication education

· Mental health certified peer specialist services

· Physical health services

· Rehabilitative mental health services as defined in Minnesota Statutes, 245I.02, subdivision 33

· Symptom management

· Therapeutic interventions

· Wellness self-management and prevention

· Other services based on client needs as identified in a client's assertive community treatment individual treatment plan

ACT teams must ensure the provision of all services necessary to meet a member's needs as identified in the member’s individual treatment plan.

ACT teams must ensure services meet the applicable standards of Minnesota Statutes, 245I, Mental Health Uniform Service Standards Act.

Billing

· Bill ACT services based on one daily rate per provider, inclusive of all the services received by a member in a calendar day

· Bill ACT services online using MN–ITS 837P

· Do not provide or bill for ACT for children under 18 years old

Assertive Community Treatment Program Billing Codes
Code	Modifier	Description	Units
H0040	No modifier	Assertive Community Treatment Program	1 Daily
H0040	HK	Forensic Assertive Community Treatment Program	1 Daily

Legal References

Minnesota Statutes, 256B.0622, subdivisions 1 through 2a, 3a, 7 through 7e, Assertive Community Treatment and Intensive Residential Treatment Services
Minnesota Statutes, 245I.01 through 245I.12, Mental Health Uniform Service Standards
Minnesota Statutes, 256B.81, Mental Health Provider Appeal Process