Behavioral Health Services
Treatment Provider Forms and Resources
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The following forms are available in various formats. To view or print out files in PDF (Portable Document Format), use the free Adobe "Acrobat Reader™" | |||
| Treatment MIS Manual, Forms and Codes | |||
| FY10 Treatment Rate Table | Excel | ||
| FY10 Rate Table Instructions | Excel | ||
| FY2005 Treatment Services Plan | |
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| Referral for Psychotropic Medication Form | |||
| UCE Authorization Protocol | |||
| Service Definitions with Codes | |||
| Financial - Co-Pay Schedule | |||
| Youth Weekly Co-Pay | |||
| Youth Residential Co-Pay | | ||
| Adult Daily Co-Pay | |||
| Adult Weekly Co-Pay | | ||
| Adult Residential Co-Pay | |||