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(1) community behavioral health services provider’s claims processing procedures if the mental health professional is an employee or volunteer of that organization; payment for services under this paragraph is subject to the same requirements and restrictions placed on a behavioral health services organization under this chapter;

(2) mental health physician clinic claims processing procedures if the mental health professional is an employee of the clinic; payment for services under this paragraph is subject to the same requirements and restrictions placed on a mental health physician clinic under this chapter; or

(3) mental health professional’s National Provider Identifier (NPI) number if providing the service as an independent practitioner; payment for services under this paragraph must be medically necessary and clinically appropriate, must be directly rendered by the licensed mental health professional, and must meet the service criteria set out in this chapter. (b) If, during an assessment, evaluation, or treatment of a recipient under 21 years of age, the provider determines that the recipient may meet the criteria in 7 AAC 135.065 for a child experiencing a severe emotional disturbance, the provider shall refer the recipient to a community behavioral health services provider that provides behavioral health rehabilitation services in the community. (c) If, during an assessment, evaluation, or treatment of a recipient 21 years of age or older, the provider determines that the recipient may meet the criteria in 7 AAC 135.055 for an adult experiencing a serious mental illness, the provider shall refer the recipient to a community behavioral health services provider that provides behavioral health rehabilitation services in the community. (d) If, during an assessment, evaluation, or treatment of a recipient, the provider discovers that the recipient meets the criteria in 7 AAC 135.020(b)(1) for an individual experiencing a substance use disorder, the provider shall refer the recipient to a community behavioral health services provider that provides substance use disorder treatment services in the community. (e) If a provider covered under this section refers a recipient to a community behavioral health services provider for rehabilitation services in accordance with (b) — (d) of this section, the provider may still continue to provide other services to the recipient that the provider is eligible to provide under 7 AAC 110. (f) A service provided under 7 AAC 140.215 by a psychologist, clinical social worker, marital and family therapist, or professional counselor enrolled under 7 AAC 105.210 must be billed by the federally qualified health center and may not be billed separately by the psychologist, clinical social worker, marital and family therapist, or professional counselor. (Eff. 4/24/2020, Register 234; am 4/16/2023, Register 246) Statutory Authority: