CRIME VICTIM COMPENSATION MENTAL HEALTH PACKET

E. THERAPY AWARDS/PAYMENTa. Upon approval of the Mental Health Treatment Plan, the Board can award aprimary victim up to 20 mental health sessions to be utilized within one yearof the award, and can award a secondary victim up to 10 sessions to beutilized within one year of the award.b. Victims and/or mental health providers are required to bill all applicableinsurance carriers prior to Crime Victim Compensation. Upon receipt of anexplanation of benefit and itemized bill, Crime Victim Compensation will issuepayment for the victim’s responsibility (co-pay, deductible, etc) up to themaximum award amounts indicated below.c. Individual therapy will be paid up to $75/hour.d. Group therapy will be paid up to $37.50.e. Family therapy will be paid up to $75 per approved mental health providerper session. The mental health provider may not bill and will not receivepayment for each member of the family; however, if each family member hasa different mental health provider, each mental health provider may bill andreceive payment for their client/victim.f. EMDR therapy will be paid up to $75 per session.g. Equine Assisted Therapy will be paid up to $75 per session. Provider doesnot need to submit a separate treatment plan; however, the primarily mentalhealth provider (if different) must note in initial Mental Health TreatmentPlan if Equine Assisted Therapy is to be utilized.F. EXTENSTION REQUESTSa. The mental health provider is required to submit a Therapy ExtensionRequest prior to the expiration of the initial award if it is necessary tocontinue treatment with the victim.b. Only one Therapy Extension Request will be considered by the Board.c. The Therapy Extension Request should provide detailed information aboutthe victim’s progress as well as information specific to the victim’s continuinggoals.d. No payment will be made for sessions held after the initial termination dateuntil approval of a Therapy Extension Request.e. Extension request requires victim/guardian signature, therapist signature,and supervising therapist signature if applicable.G. CHANGING THERAPISTSa. The victim’s new therapist must adhere to all policies/procedures as detailedin this section.H. IN-PATIENT TREATMENTa. In-patient treatment may be considered by the Board on a case-by-casebasis.b. The victim and/or provider must submit copies of intake notes and/orphysician reports for Board review.c. Upon approval, in-patient claims will be paid under current medical policies.EFFECTIVE 05/01/2013 PAGE 4 OF 5