Children’s Intensive Behavioral Health Services (CIBHS)

Revised: March 6, 2025

· Overview

· Eligible Providers

· Provider Responsibilities

· Children’s Intensive Behavioral Health Services (CIBHS) Certification Process

· Eligible Members

· Covered Services

· Noncovered Services

· Authorization

· Billing

· Legal References

Overview

Children’s Intensive Behavioral Health Services (CIBHS) is a comprehensive mental health service for children and youth with significant mental health symptoms and impairments in their functional abilities who are living in a family foster care setting or who are living with their parents or other legal guardians and are at risk of out-of-home placement. CIBHS establishes policies and practices for certification and coverage of mental health services for children and youth who require intensive intervention without 24-hour medical monitoring, as described in Minnesota Statutes, 245I.02 or the Level of Care Assessment and Necessity of Care Recommendation or Referral section of the Minnesota Health Care Programs (MHCP) Provider Manual. The level of care assessment as defined in Minnesota Statutes, 245I.02, subdivision 19, and functional assessment as defined in Minnesota Statutes, 245I.02, subdivision 17, must be updated at least every 180 days or before discharge from the service, whichever comes first. Services include psychotherapy, psychoeducation, clinical consultation, treatment plan development and crisis planning.

Eligible Providers

Only CIBHS-certified agencies and their qualified employees enrolled as MHCP providers may provide CIBHS services. Review the Certification section of the Children’s Intensive Behavioral Health Services webpage for more information.

The following entities may request MHCP certification as a CIBHS provider:

· A county-operated entity

· An Indian Health Service facility or Rule 638 tribal organization under Title 25 or Title 3 of the Indian Self-Determination Act, Public Law 93-638

· A noncounty entity

Providers are limited to:

· Mental health professionals as defined in Minnesota Statutes, 245I.04, subdivision 2.

· Clinical trainees as defined in Minnesota Statutes, 245I.04, subdivision 5.

To be certified for CIBHS, providers must be able to deliver the following core services:

· Psychotherapy

· Psychoeducation

· Crisis planning

Provider Responsibilities

Services must be delivered and documented at least three days per week, for two hours per encounter, equaling at least six hours of treatment per week. If the mental health professional, member and family agree, service units may be temporarily reduced for a period of no more than 60 days to meet the needs of the member and family or as part of transition or on a discharge plan to another service or level of care. The reasons for service reduction must be identified, documented and included in the treatment plan. Billing and payment are not allowed for days on which no services are delivered and documented.

The member’s identified family members, or any person who is identified by the member and member’s parent or guardian as being important to the member’s mental health treatment, must be involved in treatment and service delivery, unless otherwise noted in the treatment plan. Weekly family therapy or psychoeducation in the member’s home or a location most easily accessible to the family, is deemed best practice. All services must be provided in community-based settings most accessible to the member and family, such as the member’s home, daycare, or school, and the location specified on the member’s individualized treatment plan. Providers must also comply with the following requirements:

· Services must be developmentally and culturally appropriate for the member.

· Services must be deemed medically necessary as assessed by a level of care screening tool that demonstrates the individual requires intensive intervention without 24-hour medical monitoring, and documented in the diagnostic assessment that CIBHS is medically necessary to address identified symptoms, functional impairments and clinical needs.

· Each member receiving treatment services must have a standard diagnostic assessment before enrollment unless the member has a previous standard diagnostic assessment (within of 180 days of enrollment) that the member, parent and mental health professional agree still accurately describes the member’s current mental health functioning.

· Each member must be assessed for trauma history. The results must be incorporated into the member’s individual treatment plan goals and objectives.

· Documentation must be requested for all treatment and assessments the member has received from previous and current mental health, school and physical health providers. This documentation must be reviewed and incorporated into the diagnostic assessment, team consultation and treatment planning process.

· Each member must have a crisis planning plan within 10 days of initiating services and must have access to clinical phone support 24 hours per day, 7 days per week during the course of treatment. The crisis plan must demonstrate coordination with the local or regional mobile crisis intervention team.

· Each member must have an individualized treatment plan that meets Minnesota Statutes, 245I.10, subdivisions 7 and 8, and is reviewed, evaluated and approved every 180 days using the team consultation and team treatment planning process. Services must be delivered utilizing a treatment team approach, meaning services must be provided in continual collaboration and consultation with the member’s guardians, medical providers, mental health professionals, educational and social services case managers and any other individual on the member’s service team.

· Services must be delivered in continual collaboration and consultation with professionals prescribing any psychotropic medications. Individuals on the treatment team must be aware of the medication regimen and potential side effects.

· Transition planning must begin with the first treatment plan and be addressed throughout treatment to support the member’s permanency plan and post discharge mental health service needs.

Children’s Intensive Behavioral Health Services (CIBHS) Certification Process

Providers must be certified before delivering CIBHS. Visit the Children’s Intensive Behavioral Health Services (CIBHS) webpage for additional information about certification or email the Minnesota Department of Human Services’ Behavioral Health Administration at CIBHS.DHS@state.mn.us if you have questions about certification.

Eligible Members

Minnesota Health Care Programs (MHCP) members eligible for CIBHS must meet the following criteria:

· Be between the ages of birth through 20 years

· Have a standard diagnostic assessment that clearly documents the necessity for CIBHS, including intensity of treatment or level of care and medical necessity

· Have a documented diagnosis of mental illness

· Be living in a family foster care setting or residing with their parents or other legal guardians and considered at risk of out-of-home placement

· Have a level-of-care assessment completed that indicates a need for intensive intervention without 24-hour medical monitoring

Covered Services

CIBHS providers must provide the following services, as prescribed in the member’s Individual Treatment Plan (ITP):

· Psychotherapy (individual, family and group)

· Psychoeducation (individual, family and group)

· Crisis planning

· Clinical care consultation

· ITP development

Psychotherapy, psychoeducation or crisis planning must be provided for a provider to receive the daily per-client encounter rate. Clinical care consultation and individual treatment plan development may be included as part of the daily per-client encounter rate. Billing and payment are prohibited for days on which no services are delivered and documented.

All CIBHS services provided to MHCP members must be provided by a qualified mental health professional or a clinical trainee working under the supervision of a licensed mental health professional.

All CIBHS services must be delivered using trauma informed practices. Providers must be trained, certified, or credentialed in the specific treatment modality employed. Providers should utilize either Trauma Informed Child Parent Psychotherapy (TI-CPP), or Trauma Focused Cognitive Behavioral Therapy (TF-CBT) whenever appropriate. However, other evidence-based practices, best practices, promising practices, or culturally appropriate treatment may be used to meet the specific needs of members and families when approved by Minnesota Department of Human Services.

Noncovered Services

The following services are not covered in CIBHS, but may be billed separately:

· Inpatient psychiatric hospital treatment

· Mental health targeted case management

· Partial hospitalization

· Medication management

· Children’s mental health day treatment services

· Crisis response services

· Transportation

· Mental health certified family peer specialist services

The following services are not covered under CIBHS and are not billable while a child is receiving CIBHS services:

· Children’s Therapeutic Services and Supports (CTSS) (psychotherapy and skills training components)

· Mental health behavioral aide services

· Home and community-based waiver services

· Mental health residential treatment

· Room and board costs

Authorization

Refer to the Authorization section of the MHCP Provider Manual for general authorization policy and procedures.

Billing

· Providers are responsible to coordinate services. Review MHCP Billing Policy for general billing requirements and guidance when submitting claims.

· Bill CIBHS using MN–ITS 837P

· Bill CIBHS services using HCPCS code S5145

· There are no spacing requirements between sessions

· Enter the treating provider NPI number on each claim line

Use the following table for billing services.

Children’s Intensive Behavioral Health Services and Other Concurrent Services CIBHS certified agency must provide all covered services. When requesting authorization, clearly document medical necessity for the additional services, including reasons CIBHS does not or cannot meet member’s needs (for example, specialty service, transitional service, and so on)
Other Service	Is service included in CIBHS?	Can service be provided in addition to CIBHS?	Service Limitations
AMH-TCM and CMH-TCM	No	Yes	Can be billed separately. No authorization required.
CTSS Children’s Day Treatment	No	Yes	Day treatment program must request authorization.
Children’s Residential Treatment Services	No	No	Cannot be billed separately. No authorization required.
Partial Hospitalization	No	Yes	Partial hospitalization thresholds and limitations apply.
IRTS	No	Yes	CIBHS and IRTS may be provided concurrently without authorization.
CTSS and ARMHS	No	No	Rehabilitative skills training is a not a component of CIBHS services and cannot be billed separately.
Mental Health Behavioral Aide Services	No	No	Cannot be billed separately. No authorization required.
Crisis Assessment and Intervention (mobile)	No	No	Can be billed separately. No authorization required.
Crisis Stabilization – nonresidential	No	No	Cannot be billed separately. No authorization required.
Crisis Stabilization – residential	No	Yes	Services must be provided with CIBHS and residential provider. Review the Adult Residential Crisis Stabilization Services (RCS) section of the MHCP Provider Manual.
Medication Management	No	Yes	May be provided by physician or advance practice registered nurse with mental health certification.
Outpatient Psychotherapy	Yes	No	A component of CIBHS. Cannot be billed separately. No authorization required.
Inpatient Hospitalization	No	Yes	Inpatient hospitalization services are reimbursed separately from CIBHS. CIBHS claims: enter place of service code 21.
Waivered Services	No	No	Cannot be billed separately. No authorization required.
Other medical services (for example, Personal Care Assistance)	No	Yes	Service limits apply to each service.

Children’s Intensive Behavioral Health Services
Procedure Code	Brief Description	Unit
S5145 HE	Children’s Intensive Behavioral Health Services (performed by mental health professional)	Per diem
S5145 HE HN	Children’s Intensive Behavioral Health Services (performed by clinical trainee)	Per diem

Legal References

Minnesota Statutes, 245I.011, subdivision 3, Applicability
Minnesota Statutes, 245.461 to 245.468, Minnesota Comprehensive Children’s Mental Health Act
Minnesota Statutes, 245.462, Definitions
Minnesota Statutes, 256B.0625, Covered Services
Minnesota Statutes, 256B.0946, Children’s Intensive Behavioral Health Services
Minnesota Statutes, 245I, Mental Health Uniform Service Standards Act