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May 24, 2013

Treatment Services

Clinical Treatment Service

Definitions

Services must be provided by a professional who is licensed or certified to perform these functions.

Service is considered delivered only when accompanied by adequate documentation.

Service	Definition
Screening/Assessment
Substance Abuse Screening	Assess client for possible substance use disorder by administering an approved screening tool; face-to-face.
Substance Abuse Assessment	Assess and diagnose a client for substance use disorder using an approved assessment tool and the DSM-IV; face-to-face
Re-Assessment within 6 months	To update a clients status within 6 months of a completed assessment. After 6 months the client will need a new assessment.
Brief Intervention	Intervention following a substance abuse assessment, which is solution-focused, goal oriented, and behavioral/motivational/cognitive-behavioral. Goal is to assist person at risk to move along the stages of change toward health.
Treatment Planning	Develop or revise a formalized individual action plan directing treatment. Use areas of concern identified in substance abuse assessment. Follow ASAM PPC-2R dimensions and levels of care. Include clinical treatment and recovery support services to address problems. Client-centered and client-directed.
Individual counseling	Address the problems identified in the substance use disorder treatment plan. One-to-one, face-to-face.
Group counseling	Address the problems identified in the client’s treatment plan. Provided in a therapeutic setting, involving two or more clients, and facilitated by one or more licensed or certified professionals.
Family/Marriage counseling	Engage family members as a social unit to address the concerns identified in the client’s treatment plan. Single family: Face-to-face, one (1) client and family.
	Multiple family: Face to face, one or more providers treating two or more clients and families, with a maximum ratio of one provider to 10 clients or family members.
Co-Occurring Treatment services
Psychiatric/Addiction Medicine Diagnostic interview	Evaluation by a psychiatrist or ASAM-certified physician, to evaluate and diagnose a client for co-occurring substance abuse and mental health diagnoses and identify appropriateness of medication.

Mental Health Diagnostic Interview	Evaluation by a mental health professional and diagnosis of co-occurring mental health disorder.
Group Psychotherapy	Address the clients’ emotional, psychological and social concerns related to the client’s substance use disorder and co-occurring mental health disorder. Two or more clients, maximum ratio of one provider to ten clients. Face-to-face.
Individual Psychotherapy	Address the emotional, psychological, and social concerns related to the client’s substance use disorder and co-occurring mental health disorder. One provider treating one client; face to face.
Pharmacologic Interventions	Individual Psychotherapy with Medication Services by a psychiatrist or addictionist following a client’s diagnosis and prescription of medication for a co-occurring mental health disorder.
HIV/AIDS counseling	HIV/AIDS/STD/HepC counseling (one to one)
Other clinical services	Pre-treatment stabilization (ASAM Level III.2D) See ASAM PPC 2R for definition
	Residential Services ASAM III.1 See ASAM PPC 2R for definition
	Residential Services ASAM III.3 See ASAM PPC 2R for definition
Treatment Outcome Evaluation	Evaluation using approved instrument, of a client who received vouchered services, 5-7 months following intake, entered successfully into GPRA website.
Medical Care
Addiction Medicine assessment and diagnosis	Evaluation and diagnosis of a client for substance use disorder or a related medical disorder by an ASAM-certified physician. May occur in a residential or outpatient treatment setting, but not in hospital.
Addiction Medicine services	Treatment of a client for substance use disorder by an ASAM-certified physician.
Advanced Practice Nurse evaluation and diagnosis	Evaluation and diagnosis of a client for substance use disorder or related medical disorder by an Advanced Practice Nurse.
Advanced Practice Nurse services	Treatment of a client for substance use disorder or related medical disorder by an Advanced Practice Nurse.
Nursing Assessment	Assessment and nursing plan of a client for nursing needs related to substance use disorder by a registered nurse.
Public Health Nurse Visit	Services by a public health nurse to a client for health issues related to substance use disorder. Face –to-face; may be one-to-one or no more than a ratio of one nurse to four clients/partners/family members.
Medication monitoring	Services provided by a registered nurse under the supervision of a physician, for compliance and motivation of a client prescribed medication for a substance use disorder or co-occurring medical disorder, or mental health disorder.

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