Checklist: Community Mental Health Centers (CMHC) or Partial Hospitalization Program (PHP)

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Home ► Med doc checklists ► Checklist: Community Mental Health Centers (CMHC) or Partial Hospitalization Program (PHP)

Last Modified: 10/16/2024 Location: FL, PR, USVI Business: Part A

Checklist: Community Mental Health Centers (CMHC) or Partial Hospitalization Program (PHP)

This checklist is intended to provide Healthcare providers with a reference to use when responding to medical documentation requests pertaining to Community Mental Health Centers (CMHC) or Partial Hospitalization Program (PHP). It is not intended to replace published guidelines. Healthcare providers retain responsibility to submit complete and accurate documentation.

Check	Documentation description
	Documentation is for the correct beneficiary and date of service.
	Documentation is complete, legible, signed and dated by the physician or clinician.
	Physical examination upon admission (if not done within the past 30 days and/or not available from another provider) must be included in the medical record.
	A referral source (if applicable)
	Initial psychiatric evaluation, including history and mental status examination.
	Physician certification/recertification and documentation of physician supervision. Signature – The physician recertification must be signed by a physician who is treating the patient and has knowledge of the patient’s response to treatment.
	The patient’s response to the therapeutic interventions provided by the PHP/CMHC
	Treatment goals for coordination of services to facilitate discharge from the PHP/CMHC
	Treatment Plan
	Progress Notes
	Psychotherapy notes
	Group notes
	Behavior monitoring flow sheets if applicable
	Treatment team, person-centered active treatment plan, and coordination of services
	Evidenced that an advanced beneficiary notice of non-coverage (ABN) was provided to the beneficiary, if applicable.

Disclaimer

This checklist was created as an aid to assist providers. This aid is not intended as a replacement for the documentation requirements published in national or local coverage determinations, or the CMS documentation guidelines. It is the responsibility of the provider of services to ensure the correct, complete, and thorough submission of documentation.

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