SMHS Playbook
The Specialty Mental Health Playbook is a collection of all requirements and guidelines from CalAIM billing Specialty Mental Health Manual. Included are myAvatar specific recommendations for system configuration to comply with the CalAIM requirements. The Playbook also contains Cal-PM and MSO enhancement information.
The Playbook is divided into sections corresponding to the Billing Manual.
Playbook sections
| Section | Description/Notes |
|---|---|
| Mental Health Eligibility | Chapter 3 of Billing Manual - This section details Medi-Cal Eligibility Determination and Medi-Cal Eligibility Review. |
| Mental Health Covered Services | Chapter 4 of Billing Manual - This section details covered Specialty Mental Health Services and provider certification. |
| Mental Health Claim Processing | Chapter 5 of Billing Manual - This section relates to the SD/MC Claiming Process. |
| Cal-PM and MSO Enhancements | This section give information on Cal-PM and MSO Enhancements |
| Mental Health Funding | Chapter 6 of Billing Manual - This section provides information on the funding relationship between Federal Share, State share and Proposition 30, and the County Share. |
| Mental Health Out-of-State Claims | Chapter 7 of Billing Manual |
| Rendering Providers/Practitioners Disciplines | Table 1 in Billing Manual - These abbreviations are used in the Service Code lists. |
| Place of Service Codes | Table 2 in Billing Manual - These are the Place of Service Codes used with Service Codes. |
| Modifiers | Table 3 in Billing Manual - These are the Modifiers that are attached to Service Codes. |
Service Codes List
- Assessment Codes
- Crisis Intervention Codes
- Medication Support Codes
- Mobile Crisis Intervention
- Peer Support Service Codes
- Plan Development Codes
- Referral Codes
- Rehabilitation Codes
- Supplemental Services
- Therapeutic Behavioral Services
- Therapy Codes
- Existing 24-Hr and Day Services