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Including Documentation and Coding Information  \nESTABLISHED:  \nJanuary 15 , 2026  \nTable of Contents  \nOverview  \nIntroduction ................................................................................................................................ 7  \nManual Priority........................................................................................................................... 8  \nContact Information ................................................................................................................... 9  \nPart I: Mental Health  \nIntroduction ................................................................................................................................ 7  \nManual Priority........................................................................................................................... 8  \nContact Information ................................................................................................................... 9  \nScreening Tools ....................................................................................................................... 10  \nTransition of Care Tool ............................................................................................................ 11  \nNo Wrong Door for Mental Health Services ............................................................................ 12  \nConcurrent Non-Specialty Mental Health Services and Specialty Mental Health Services ... 12  \nTimely Access to Mental Health Services ............................................................................... 13  \nInitial Intake Forms .................................................................................................................. 14  \nAssessment ............................................................................................................................. 19  \nDiagnosis .................................................................................................................................26  \nMedical Necessity for Specialty Mental Health Services ........................................................26  \nNotice of Adverse Benefit Determination (NOABD) ................................................................29  \nProblem List ............................................................................................................................. 30  \nTreatment Plan Requirements ................................................................................................ 31  \nProgress Notes ........................................................................................................................ 31  \nPrior Authorization and Concurrent Review for Specialty Mental Health Services ................33  \nService Delivery Types............................................................................................................40  \nOther Charting and Billing Considerations .............................................................................. 61  \nTable of Contents  \nPart II: Substance Use Services  \nAccess to Care ....................................................................................................................... 66  \nTimeliness and Access Standards .......................................................................................... 67  \nTimely Access Requirements .................................................................................................. 68  \nInitial Contact Log (ICL) Overview .......................................................................................... 68  \nCovered DMC-ODS Levels of Care (LOC) and Service Components ..............................69  \nEarly Intervention Services (ASAM Level 0.5) ........................................................................ 69  \nOutpatient Treatment Services (ASAM Level 1.0) ...............................................................","cbCaidAiFFFHK1ZJ","https://ap.wps.com/l/cbCaidAiFFFHK1ZJ","pdf",1459879,174,"English","# Overview\n## Introduction\n## Manual Priority\n## Contact Information\n# Part I: Mental Health\n## Introduction\n## Manual Priority\n## Contact Information\n## Screening Tools\n## Transition of Care Tool\n## No Wrong Door for Mental Health Services\n## Concurrent Non-Specialty Mental Health Services and Specialty Mental Health Services\n## Timely Access to Mental Health Services\n## Initial Intake Forms\n## Assessment\n## Diagnosis\n## Medical Necessity for Specialty Mental Health Services\n## Notice of Adverse Benefit Determination (NOABD)\n## Problem List\n## Treatment Plan Requirements\n## Progress Notes\n## Prior Authorization and Concurrent Review for Specialty Mental Health Services\n## Service Delivery Types\n## Other Charting and Billing Considerations\n# Part II: Substance Use Services\n## Access to Care\n## Timeliness and Access Standards\n## Timely Access Requirements\n## Initial Contact Log (ICL) Overview\n## Covered DMC-ODS Levels of Care (LOC) and Service Components\n## Early Intervention Services (ASAM Level 0.5)\n## Outpatient Treatment Services (ASAM Level 1.0)\n## Intensive Outpatient Treatment Services (ASAM Level 2.1)\n## Partial Hospitalization Services (ASAM Level 2.5)\n## Residential Treatment and Inpatient Services (ASAM Level 3.1-4.0)\n## Narcotic Treatment Program (NTP)/Opioid Treatment Program (OTP)\n## Withdrawal Management (WM) Services\n## Medication Assisted Treatment (MAT)\n## Recovery Services\n## Contingency Management/Recovery Incentives\n## Care Coordination\n## Clinician Consultation\n## Medi-Cal Peer Support Services\n## Evidence Based Practices\n## Treatment Service Components\n## Group Counseling\n## Patient Education\n## Individual Counseling","[{\"question\":\"What does the guide cover at a high level?\",\"answer\":\"It compiles service documentation and coding information for both mental health and substance use services, including tools, assessments, service delivery types, and charting/billing considerations.\"},{\"question\":\"How does the guide address timely access to mental health services?\",\"answer\":\"It includes sections on timeliness and timely access requirements, describing access principles and the related intake and assessment workflow.\"},{\"question\":\"What service types are included for substance use care?\",\"answer\":\"It covers early intervention, multiple outpatient and partial hospitalization levels, residential and inpatient services, narcotic/opioid treatment programs, withdrawal management, medication assisted treatment, and recovery services.\"}]","Scope-of-Service Reference Guide - Manual Priority and Contact Information | PDF",1789984587,438]