Children’s Mental Health Residential Treatment, 3rd Path/Children’s Mental Health Residential Services Path and Institution for Mental Disease

Revised: May 23, 2025

· Overview

· Eligible Providers

· Eligible Members

· Covered Services

· Level of Care Determination

· Discharge Transition

· Billing

· Legal References

Overview

Children’s mental health residential treatment is a 24-hour-a-day program. Services are provided under the clinical supervision of a mental health professional in a community setting, other than an acute-care hospital or regional treatment center.

Children’s residential treatment must be designed to:

· Help the child manage their mental health symptoms;

· Prevent placement in settings that are more intensive, costly, or restrictive than necessary and be appropriate to meet the child’s needs;

· Help the child improve family living and social interaction skills;

· Help the child gain the necessary skills to return to the community;

· Stabilize crisis admissions; and

· Work with families throughout the placement to improve the ability of families to care for children with severe emotional disturbance in the home.

Refer to the 3rd Path/Children’s Mental Health Residential Services webpage for children and youth entering care through the 3rd Path/Children’s Mental Health Residential Services.

Eligible Providers

Providers must be facilities that are:

· Licensed by the Department of Human Services as a children’s mental health residential treatment provider;

· Providing treatment under clinical supervision of a mental health professional;

· Under contract with a lead county to provide children’s residential services that includes admission, continued stay, discharge planning; and

· Enrolled as a Minnesota Health Care Programs (MHCP) provider. Refer to Enrollment with Minnesota Health Care Programs (MHCP) section of the MHCP Provider Manual.

Eligible Members

To be eligible for this service, a member must:

· Be under age 18 years;

· Be eligible for Minnesota Health Care Programs;

· Meet the criteria for severe emotional disturbance; and

· Have been determined eligible for residential treatment by the county, managed care organization or tribe before placement in the facility. 3rd Path participants do not require initiative tribe and county determinations.

Covered Services

Covered services include, but are not limited to, the following. Refer to Minnesota Rules, 2960.0590 for a complete and detailed description.

· Individual and group psychotherapy

· Crisis assistance

· Medication education

· Independent living skills

· Recreation and leisure skills activities

· Interpersonal skills

· Vocational skills

· Assistance in parenting skills and family support services

Level of Care Determination

Before admission, except in the case of emergency admission, all children referred for treatment of severe emotional disturbance must receive an assessment by a mental health professional deeming medical necessity for residential treatment. The following are responsible for determining the level of care:

· The county will facilitate the level of care determination when the child is enrolled in fee-for-service MHCP.

· The enrolled health plan determines the level of care when the child is enrolled in a Managed Care Organization (MCO).

· The Indian Health Services or 638 tribal health facility determines the level of care when Indian Health Services funds or a tribally owned facility are used.

· When multiple entities have a role in authorizing, paying, or monitoring treatment services, the entities shall coordinate level of care determination activities to the extent possible.

Length of stay is based on the child’s residential treatment need and is subject to the six-month administrative review of the out-of-home placement plan (Does not apply to services accessed through 3rd path).

Discharge Transition

The facility must:

· Begin discharge planning within 30 days after the child enters residential treatment and be updated every 60 days

· Plan for and assist children and their families in making the transition to less-restrictive community-based services.

· Arrange appropriate follow-up care in the community.

· Provide notification to the child’s case manager to monitor and coordinate the transition for follow-up care in the community, if applicable, before a child is discharged.

· Provide, at a minimum, a 10-day written notification of the child’s discharge to:

· The parent or caretaker,

· The local education agency in which the child is enrolled, and

· The receiving education agency to which the child will be transferred upon discharge.

When the child has an individualized education program, the notice shall include a copy of the individualized education program.

Billing

· Bill using MN–ITS 837P.

· Enter a span of dates within a month. For example, if billing for services during May and June, bill May dates on one claim and bill June dates on another claim.

· Use procedure code H0019 for the monthly negotiated rate.

· Enter the place of service code 99.

· Enter the number of units (1 unit = 1 day) based on the dates of service.

Counties:

· Refer to the county link for fiscal reporting and accounting, Title IV-E Per Diem Rates for Children's Residential Facilities and Child Placing Agencies, for reimbursement rates

· Enter the county NPI or UMPI as the pay-to-provider

· Enter the facility’s NPI number as the rendering provider

Tribal Entities:

· Reimbursement is based on the Mental Health encounter rate, per Tribal and Federal Indian Health Services guidelines

· Enter the tribal NPI or UMPI as the pay-to-provider

· Enter the facility’s NPI number as the rendering provider

3rd Path room and board billing:

· Bill using MN–ITS 837I to bill for room and board revenue code 1001.

· Include the date of admission

· Type of Bill (TOB) 86X. Refer to the Room and Board Services for Adult Residential Crisis Stabilization, Children's Mental Health Residential Treatment and Intensive Residential Treatment Services MN–ITS user manual.

· Value Code 80

· Enter the number of days for covered inpatient days

· Value Code 81

· Enter the number of days for noncovered inpatient days

· Bill room and board for direct mental health service days only

· Bill room and board service days that are authorized by the MCO directly to MHCP

Descriptions of codes and units

Code	Description	Units
H0019	Children’s residential treatment	1 Day
1001	Room and Board	1 Day

Legal References

Minnesota Statutes, 256B.0945 Services for Children with Emotional Disturbance
Minnesota Statutes, 245.4882 Residential Treatment Services
Minnesota Statutes, 245.4885 Screening for Inpatient and Residential Treatment