Common use of Specialty Mental Health Services Clause in Contracts

Specialty Mental Health Services. Only the services specified in the Client Plan and authorized by the MHP or the MHP’s designee will be subject to payment by the MHP. Services contracted under this agreement are specified below: Service Description Provider Currently Certified MHP will Certify Provider Provider Not Certified Contracted Service (indicate with check mark) Mental Health Services a a Case Management, Brokerage a a Medication Support Services a a Crisis Intervention a a Crisis Stabilization a Therapeutic Behavioral Services a Day Treatment Intensive - Half-day a Day Treatment Intensive - Full day a a Day Rehabilitation - Half-day a Day Rehabilitation - Full day a a

Specialty Mental Health Services. Only the services specified in the Client Plan and authorized by the MHP or the MHP’s designee will be subject to payment by the MHP. Services contracted under this agreement are specified below: Service Description Provider Currently Certified MHP will Certify Provider Provider Not Certified Contracted Service (indicate with check markxxxx) Mental Health Services a a Case Management, Brokerage a a Medication Support Services a a Crisis Intervention a a Crisis Stabilization a Therapeutic Behavioral Services a a Day Treatment Intensive - Half-day a Day Treatment Intensive - Full day a a Day Rehabilitation - Half-day a Day Rehabilitation - Full day a a

Specialty Mental Health Services. Only the services specified in the Client Plan and authorized by the MHP or the MHP’s designee will be subject to payment by the MHP. Services contracted under this agreement are specified below: Service Description Provider Currently Certified MHP will Certify Provider Provider Not Certified Contracted Service (indicate with check mark) Mental Health Services a a ✓ ✓ Case Management, Brokerage a a ✓ ✓ Medication Support Services a a ✓ ✓ Crisis Intervention a a ✓ ✓ Crisis Stabilization a ✓ Therapeutic Behavioral Services a ✓ Day Treatment Intensive - Half-day a ✓ Day Treatment Intensive - Full day a a ✓ ✓ Day Rehabilitation - Half-day a ✓ Day Rehabilitation - Full day a a✓ ✓

Specialty Mental Health Services. Only the services specified in the Client Plan and authorized by the MHP or the MHP’s designee will be subject to payment by the MHP. Services contracted under this agreement are specified below: Service Description Provider Currently Certified MHP will Certify Provider Provider Not Certified Contracted Service (indicate with check markxxxx) Mental Health Services a a x x Case Management, Brokerage a a x x Medication Support Services a a x x Crisis Intervention a a Crisis Stabilization a Therapeutic Behavioral Services a x x Day Treatment Intensive - Half-day a Day Treatment Intensive - Full day a a Day Rehabilitation - Half-day a Day Rehabilitation - Full day a ax x

Specialty Mental Health Services. Only the services specified in the Client Plan and authorized by the MHP or the MHP’s designee will be subject to payment by the MHP. Services contracted under this agreement are specified below: Service Description Provider Currently Certified MHP will Certify Provider Provider Not Certified Contracted Service (indicate with check markxxxx) Mental Health Services a a x x Case Management, Brokerage a a x x Medication Support Services a a x x Crisis Intervention a a x Crisis Stabilization a x Therapeutic Behavioral Services a x Day Treatment Intensive - Half-day a x Day Treatment Intensive - Full day a a x x Day Rehabilitation - Half-day a x Day Rehabilitation - Full day a ax x

Specialty Mental Health Services. Only the services specified in the Client Plan and authorized by the MHP or the MHP’s designee will be subject to payment by the MHP. Services contracted under this agreement are specified below: Service Description Provider Currently Certified MHP will Certify Provider Provider Not Certified Contracted Service (indicate with check mark) Mental Health Services a a X X Case Management, Brokerage a a X X Medication Support Services a a X X Crisis Intervention a a Crisis Stabilization a Therapeutic Behavioral Services a X X Day Treatment Intensive - Half-day a Day Treatment Intensive - Full day a a Day Rehabilitation - Half-day a Day Rehabilitation - Full day a aX X

Specialty Mental Health Services. Only the services specified in the Client Plan and authorized by the MHP or the MHP’s designee will be subject to payment by the MHP. Services contracted under this agreement are specified below: Service Description Provider Currently Certified MHP will Certify Provider Provider Not Certified Contracted Service (indicate with check markxxxx) Mental Health Services a a X X Case Management, Brokerage a a X X Medication Support Services a a X X Crisis Intervention a a X Crisis Stabilization a X Therapeutic Behavioral Services a X X Day Treatment Intensive - Half-day a X Day Treatment Intensive - Full day a a X Day Rehabilitation - Half-day a X Day Rehabilitation - Full day a aX X

Specialty Mental Health Services. Only the services specified in the Client Plan and authorized by the MHP or the MHP’s designee will be subject to payment by the MHP. Services contracted under this agreement are specified below: Service Description Provider Currently Certified MHP will Certify Provider Provider Not Certified Contracted Service (indicate with check mark) Mental Health Services a a X X Case Management, Brokerage a a X X Medication Support Services a a X X Crisis Intervention a a X X Crisis Stabilization a X Therapeutic Behavioral Services a X Day Treatment Intensive - Half-day a X Day Treatment Intensive - Full day a a X Day Rehabilitation - Half-day a X Day Rehabilitation - Full day a aX X

Specialty Mental Health Services. Only the services specified in the Client Plan and authorized by the MHP or the MHP’s designee will be subject to payment by the MHP. Services contracted under this agreement Contract are specified below: Service Description Provider Currently Certified MHP will Certify Provider Provider Not Certified Contracted Service (indicate with check mark) Mental Health Services a a X X Case Management, Brokerage a a X X Medication Support Services a a X X Crisis Intervention a a X X Crisis Stabilization a Therapeutic Behavioral Services a Day Treatment Intensive - Half-day a Day Treatment Intensive - Full day a a Day Rehabilitation - Half-day a Day Rehabilitation - Full day a aday

Specialty Mental Health Services. Only the services specified in the Client Plan and authorized by the MHP or the MHP’s designee will be subject to payment by the MHP. Services contracted under this agreement are specified below: Service Description Provider Currently Certified MHP will Certify Provider Provider Not Certified Contracted Service (indicate with check mark) Mental Health Services a a Case Management, Brokerage a a Medication Support Services a a Crisis Intervention a a Crisis Stabilization a Therapeutic Behavioral Services a a Day Treatment Intensive - Half-day a Day Treatment Intensive - Full day a a Day Rehabilitation - Half-day a Day Rehabilitation - Full day a a