Neurobehavioral Tobacco Crisis Crisis Family Outpatient Medication Status Exam/ Cessation Provider Resolution Residential Services Services Psychological Counseling Services Services Testing Physician X X X X X X X Physician’s X X X X X Assistant Psychiatrist X X X X X X X Psychologist X X X X X X Psych X Examiner LCSW/LCPC /LMFT/ X X X X X LMSW X X X X X X RNBC/RNC X X X X X MHRT X X X DSP X PROFESSIONAL STAFF SUBSTANCE ABUSE SERVICES Intensive Tobacco Outpatient MAT with Provider Outpatient Cessation Services Methadone Services Counseling Physician X X X X (MD/DO)/Psychologist APRN X X X X LADC/CADC X X X X LCSW/LCPC/LMFT X X X X 65.15 APPENDIX II Service Services not allowed Concurrently Crisis Resolution Children’s Assertive Community Treatment (ACT) Crisis Residential Children’s Assertive Community Treatment (ACT) Outpatient- Children’s Assertive Community Treatment (ACT) Comprehensive Children’s Home and Community Based Treatment/ Collateral Contacts Assessment/Therapy MAT with Methadone Family Children’s Assertive Community Treatment (ACT) Psychoeducation Children’s Home and Community Based Treatment/ Collateral Contacts
Provider Crisis Resolution Services Crisis Residential Services Outpatient Services Family Medication Services Neurobehavioral Status Exam/ Psychological Testing Tobacco Cessation Counseling Physician X X X X X X X Physician’s Assistant X X X X X Psychiatrist X X X X X X X Psychologist X X X X X X Psych Examiner X LCSW/LCPC /LMFT/ LMSW X X X X X X X X X X X RNBC/RNC X X X X X MHRT X X X DSP X PROFESSIONAL STAFF SUBSTANCE ABUSE SERVICES Provider Outpatient Services Intensive Outpatient Services MAT with Methadone Tobacco Cessation Counseling Physician (MD/DO)/Psychologist X X X X APRN X X X X LADC/CADC X X X X LCSW/LCPC/LMFT X X X X 65.15 APPENDIX II Service Services not allowed Concurrently Crisis Resolution Children’s Assertive Community Treatment (ACT) Crisis Residential Children’s Assertive Community Treatment (ACT) Outpatient- Comprehensive Assessment/Therapy Children’s Assertive Community Treatment (ACT) Children’s Home and Community Based Treatment/ Collateral Contacts MAT with Methadone Family Psychoeducation Children’s Assertive Community Treatment (ACT) Children’s Home and Community Based Treatment/ Collateral Contacts
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