<html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><title></title><meta name="Generator" content="PowerTools for Open XML" /><style>p.s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8P0 { margin-top: 0; margin-bottom: 0; margin-left: 0; margin-right: 0; text-indent: 0.00in; text-align: justify; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; } span.s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0 { color: black; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0-000000 { color: #0000FF; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0-000001 { color: black; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8000002 { color: black; background: white; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0-000003 { color: #0000FF; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">    </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:41:02"><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0-000000">67:16:41:02</span></a><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0-000001">.  Mental health service requirements.</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0"> To be covered under this chapter, mental health services are limited to services </span><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">that are </span><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">established in this chapter </span><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">and</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0"> meet the following requirements:</span></p><p dir="ltr" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8000002"> </span></p><p dir="ltr" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">    (1)  The</span><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">re must be a diagnostic assessment prepared by a</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0"> mental health provider </span><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">in accordance with</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0"> § </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:41:04"><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0-000003">67:16:41:04</span></a><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">;</span></p><p dir="ltr" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">    (2)  The diagnostic assessment </span><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">must </span><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">contain a primary </span><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">mental health disorder </span><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">diagnosis </span><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">code set forth in</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0"> § </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:41:05"><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0-000003">67:16:41:05</span></a><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">;</span></p><p dir="ltr" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">    (3)  The</span><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">re must be an individual trreatment plan that is prepared by a</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0"> mental health provider </span><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">and</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0"> meets the requirements of §§ </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:41:06"><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0-000003">67:16:41:06</span></a><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0"> and </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:41:07"><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0-000003">67:16:41:07</span></a><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">;</span></p><p dir="ltr" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">    (4)  The treatment </span><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">must be provided </span><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">directly to the recipient</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0"> or via collateral contact</span><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">;</span></p><p dir="ltr" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">    (5)  The treatment </span><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">must be</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0"> documented in the recipient's clinical record </span><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">in accordance with</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0"> § </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:41:08"><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0-000003">67:16:41:08</span></a><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">; and</span></p><p dir="ltr" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">    (6)  The treatment </span><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">must be</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0"> medically necessary </span><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">in accordance with</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0"> § </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:01:06.02"><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0-000003">67:16:01:06.02</span></a><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">.</span></p><p dir="ltr" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8000002"> </span></p><p dir="ltr" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">    </span><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">If the</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0"> requirements </span><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">set forth in this section are not met, the department may determine that the mental health services are noncovered</span><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">.</span></p><p dir="ltr" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8000002"> </span></p><p dir="ltr" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">    Mental health services may be provided to a recipient during the 30-day time period the mental health provider has to complete the diagnostic assessment, if the requirements set forth in this section are met and the mental health provider has made a provisional diagnosis of a mental health disorder.</span></p><p dir="ltr" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8000002"> </span></p><p dir="ltr" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">    </span><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0-000001">Source:</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0"> 22 SDR 6, effective July 26, 1995; 45 SDR 82, effective December 10, 2018</span><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">; 49 SDR 21, effective September 12, 2022</span><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">.</span></p><p dir="ltr" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">    </span><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0-000001">General Authority:</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=28-6-1"><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0-000003">28-6-1</span></a><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">.</span></p><p dir="ltr" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">    </span><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0-000001">Law Implemented:</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=28-6-1"><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0-000003">28-6-1</span></a><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">(1)(2)</span><span style="white-space: pre-wrap;" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8C0">.</span></p><p dir="ltr" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s8ce9a0b8-1cfe-4878-9a06-3da8f03defe8000002"> </span></p></div></body></html>