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.