Community Health Plan of Washington (CHPW) would like to provide clarification about Intensive Residential Treatment (IRT) and how to bill for IRT services.
The italicized text below is from the Health Care Authority’s Mental Health Services Billing Guide:
Intensive Residential Treatment teams (IRT) is a Medicaid-funded range of service components that includes individualized, intensive, coordinated, comprehensive, culturally competent, and outreach-based services for adults age 18 and older living in adult family homes and assisted living facilities licensed by the Home and Community Living Administration.
IRT services are delivered by a multi-disciplinary, mental health staff who work as a team and provide most of the treatment, rehabilitation, and support services clients need to achieve their goals. The team provides services with extended availability and a greater number of contacts than available for most outpatient services. Services are provided to the client where they live, and the team coordinates with the facility where the client lives to better work with the client.
- Inclusions: Criteria for entry to this program are specified on the IRT webpage.
The following services are excluded from IRT programs:
- Day Support
- High Intensity Treatment
- WA-PACT
- WISe
- New Journeys
- Mental health services are provided in a residential setting
- Intensive outpatient treatment and partial hospitalization
- Other per diem codes
IRT is considered outpatient as it takes place where the patient is residing and not in a hospital setting. Therefore, billing an admission (“admit”) date for IRT is inappropriate.
Please see the following HCA resources for more information:
If you have any questions about billing IRT , please contact [email protected].
