Intensive In-Home Services: Medicaid and NCHC Billable Service

Service Definition and Required Components

The Intensive In-Home (IIH) service is a team approach designed to address the identified needs of children and adolescents who, due to serious and chronic symptoms of an emotional, behavioral, or substance use disorder, are unable to remain stable in the community without intensive interventions.

This service may only be provided to beneficiaries through age 20. This medically necessary service directly addresses the beneficiary’s mental health or substance use disorder diagnostic and clinical needs. The needs are evidenced by the presence of a diagnosable mental, behavioral, or emotional disturbance (as defined by DSM-5, or any subsequent editions of this reference material), with documentation of symptoms and effects reflected in the Comprehensive Clinical Assessment and the Person-Centered Plan (PCP). This team provides a variety of clinical rehabilitative interventions available 24 hours per day, 7 days per week, 365 days per year.

This is a time-limited, intensive child and family intervention based on the clinical needs of the beneficiary. The service is intended to accomplish the following:

• a. reduce presenting psychiatric or substance use disorder symptoms;
• b. provide first responder intervention to diffuse current crisis;
• c. ensure linkage to community services and resources; and
• d. prevent out of home placement for the beneficiary.

IIH services are delivered to children and adolescents, primarily in their living environments, with a family focus, and IHH services include but are not limited to the following interventions as clinically indicated:

• a. individual and family therapy;
• b. substance use disorder treatment interventions;
• c. developing and implementing a home-based behavioral support plan with the beneficiary and the beneficiary’s caregivers;
• d. psychoeducation imparts information about the beneficiary’s diagnosis, condition, and treatment to the beneficiary, family, caregivers, or other individuals involved with the beneficiary’s care;
• e. intensive case management includes the following:
  • 1. assessment;
  • 2. planning;
  • 3. linkage and referral to paid and natural supports; and
  • 4. monitoring and follow up.
• f. arrangements for psychological and psychiatric evaluations; and
• g. crisis management.

The IIH Team shall provide “first responder” crisis response, as indicated in the PC