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In accordance with state legislation, the Mental Hygiene Administration (MHA) in conjunction with the Core Service Agencies (CSAs) has implemented the Public Mental Health System (PMHS). MAPS-MD helps administer the system. MAPS-MD, known as an Administrative Service Organization (ASO), provides the following services:
  • 24-hour access for clinically related calls
  • Referring individuals to qualified service providers
  • Preauthorization of non-emergency care
  • Review of Authorization Plans to assist in determining whether an individual meets Medical Necessity Criteria and is part of the Public Mental Health System
  • Conducting utilization reviews of services
  • Collecting data
  • Processing claims
  • Remitting payments
  • Assisting with the evaluation of the PMHS


The following manual should be used as a reference guide when a provider is in need of specific information. Additional sections or revisions will be placed on this web site. If you cannot find an answer to your questions, please refer to the contact list.

 

 
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Matrix Section

Ø      Service Matrix

Ø      PMHS Reimbursement Schedule

Ø      ICD-9/DSM-IV-TR Crosswalk

Chapter 1:  Welcome to Maryland’s Public Mental Health System (PMHS)

Ø      Overview

Ø      Introduction

Ø      Responsibilities

Chapter 2:  Participation in the State PMHS

Ø      General Description

Ø      Change of Status or Address

Ø      The On-line Provider Directory

Ø      Provider Terminations

Ø      Consumer Referrals

Chapter 3:  Uninsured Eligible Consumers

Ø      Coverage Groups

Ø      Application/Registration Process

Ø      Eligibility Requirements

Ø      Financial Criteria

Ø      Certification Period

Ø      Recertification Process

Ø      Pending Medical Assistance

Ø      Uninsured Eligible Services

Chapter 4:  General Information

Ø      Provider Audits

Ø      Alternative or Additional Services

Ø      Authorization Requests

Ø      Consumers with Private Insurance and Medical Assistance

Chapter 5:  Service Descriptions

Ø      5.1 - Inpatient Hospital Psychiatric Services

Ø      5.2 - Residential Treatment Services

Ø      5.3 - Partial Hospitalization Services/Day Treatment

Ø      5.4 - Emergency Services in a Licensed Hospital Emergency Room

Ø      5.5 - Mobile Treatment Services

Ø      5.6 - Supported Employment Services

Ø      5.7 - Respite Services

Ø      5.8 - Enhanced Support Services

Ø      5.9 - Reserved for Future Use

Ø      5.10-Reserved for Future Use

Ø      5.11-Residential Crisis Services

Ø      5.12-Occupational Therapy Services

Ø      5.13-Psychiatric Rehabilitation Program Services (PRP)

Ø      5.14-Residential Rehabilitation Program Services (RRP)

Ø      5.15-Interdisciplinary Team Treatment Planning

Ø      5.16-Reserved for Future Use

Ø      5.17-Outpatient Mental Health Services

Ø      5.18-Intensive Outpatient Treatment Services (IOP)

Ø      5.19-Reserved for Future Use

Ø      5.20-Psychological Testing Services

Ø      5.21-Hospital Consultation Services

Ø      5.22-Nursing Home Psychiatric Consultations

Chapter 6:  Medical Necessity Criteria for Use by the Maryland PMHS

Chapter 7:  Deaf Services

Chapter 8:  Forensic Services

Chapter 9:  Grievances and Appeals

Chapter 10:Retrospective Review Process

Chapter 11:Coordination of Care

Ø      Coordination with Primary Care Physicians and HealhChoice MCOs

Ø      Rare and Expensive Case Management

Ø      Coordination of Care for Consumers with Severe and Persistent Mental Illness

Chapter 12: Laboratory Services

Chapter 13: Pharmacy

Chapter 14: Transportation

Chapter 15: Reserved for Future Use

Chapter 16: Claims and Billing

Ø      Addendum:  Emergency Petition Billing Manual

Ø      Addendum:  PMHS Explanation Codes for the Claims System

Ø      Addendum:  HIPPA/MAPS-MD EOP Code Crosswalk

Chapter 17: Forms

Appendix A:  Certificate of Need for Services Rules and Guidelines

Appendix B:  Eligibility Verification Process

Appendix C:  Reserved for Future Use

Appendix D:  MAPS-MD Glossary of Terms

Appendix E:  Medicaid Coverage Groups

Appendix F:  Reserved for Future Use

Appendix G: Reserved for Future Use

Appendix H: Medicare & Medicaid Issues

Appendix I:   Reserved for Future Use

Appendix J:  Reserved for Future Use

Appendix K: Emergency Room Consultation Procedures

Appendix L:  Excluded Diagnoses

Appendix M: State Approved Medicaid Provider Types for the PMHS

 
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