The following rule supplements information contained in the fee schedules regarding coverage and reimbursement for psychiatric services.
Treatment of mental conditions to workers is to be goal directed, time limited, intensive, and limited to conditions caused or aggravated by the industrial condition. Psychiatric services to workers are limited to those provided by psychiatrists, clinical PhD psychologists, and psychiatric advanced registered nurse practitioners and according to department policy. Psychiatrists and psychiatric advanced registered nurse practitioners may prescribe medications while providing concurrent care. For purposes of this rule, the term "psychiatric" refers to treatment by psychologists, psychiatric advanced registered nurse practitioners, and psychiatrists.
Initial evaluation, and subsequent treatment must be authorized by department staff, as outlined by department policy. The report of initial evaluation, including test results, and treatment plan are to be sent to the worker's attending provider, as well as to the department or self-insurer. A copy of sixty-day narrative reports are to be sent to the department or self-insurer and to the attending provider.
All providers are bound by the medical aid rules in chapter 296-20
WAC. Reporting requirements are defined in chapter 296-20
WAC. In addition, the following are required: Testing results with scores, scales, and profiles; report of raw data sufficient to allow reassessment by a panel or independent medical examiner. Use of the current Diagnostic and Statistical Manual of the American Psychiatric Association axis format in the initial evaluation and sixty-day narrative reports, and explanation of the numerical scales are required.
A report to the department will contain, at least, the following elements:
Assessment of the worker's condition and goals accomplished; and
Plan of care.
The codes, reimbursement levels, and other policies for psychiatric services are listed in the fee schedules.
[Statutory Authority: RCW 51.04.020, 51.04.030. 09-14-104, § 296-21-270, filed 6/30/09, effective 7/31/09. Statutory Authority: RCW 51.04.020, 51.04.030 and 1993 c 159. 93-16-072, § 296-21-270, filed 8/1/93, effective 9/1/93.]