Mental Health Outpatient Therapy

To ensure effective treatment, a Plan of Care (POC) is required for all psychiatric services, including medication management. The initial POC is developed during the first appointment, addressing the individual’s immediate mental health, safety, and treatment needs based on an assessment by a licensed practitioner in collaboration with the individual.

The POC must align with the individual’s psychiatric diagnosis, which is documented using the DSM and recorded alongside the individual’s current mental status in medical progress notes.

Medical Necessity Criteria

Outpatient psychiatric services are considered appropriate when the individual meets the following criteria:

• Needs treatment to maintain emotional or behavioral progress or to restore cognitive functioning that has declined.
• Struggles with peer relationships, authority figures, impulsivity, or hyperactivity, impacting daily interactions.
• Experiences clinical depression or other significant symptoms that affect focus, learning, employment, education, or social participation.