Behavioral health; long-term residential (non-medical, non-acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem
HCPCS code
Name of the Procedure:
Behavioral Health Residential Treatment (H0019)
Common names: Long-term residential treatment, Residential behavioral health care
Technical/Medical term: Long-term residential behavioral health care without room and board, per diem
Summary
This procedure involves extended residential care in a treatment program for individuals grappling with behavioral health issues. It is a non-medical, non-acute level of care where patients stay in a residential facility for more than 30 days. Room and board are not included in this service.
Purpose
Medical Conditions/Problems Addressed:
- Chronic mental health conditions
- Substance use disorders
- Severe emotional or behavioral issues
Goals/Expected Outcomes:
- Stabilization of behavioral health conditions
- Development of coping and life skills
- Long-term improvement in mental health and quality of life
- Reduction in hospitalizations and emergency room visits
Indications
Specific Symptoms or Conditions:
- Persistent mental health issues unresponsive to outpatient treatment
- Severe substance abuse requiring a structured environment
- Situations where home environment is not conducive to recovery
Patient Criteria:
- Patients who have completed detoxification if applicable
- Individuals committed to long-term intensive therapy
- Adequate self-care capability for daily needs
Preparation
Pre-Procedure Instructions:
- Comprehensive health and psychological evaluation
- Consent form completion and understanding of the treatment plan
- Possible medication adjustments or discontinuation under medical supervision
Diagnostic Tests/Assessments:
- Baseline mental and physical health assessment
- Possible lab tests to ensure readiness for residential stay
- Substance abuse screening if applicable
Procedure Description
Admission:
- Thorough intake process including documentation review and assessments
- Orientation session to familiarize with facility rules, schedules, and resources
Day-to-Day Care:
- Individual therapy sessions with licensed therapists
- Group therapy and support groups
- Educational workshops on mental health, coping strategies, and life skills
- Recreational and therapeutic activities (e.g., art therapy, exercise programs)
Tools and Equipment:
- Therapy rooms, recreational spaces
- Assessment tools and diagnostic tests as needed
- Medication management systems where applicable
Anesthesia or Sedation: Not applicable
Duration
The residential stay typically exceeds 30 days, depending on individual progress and treatment goals.
Setting
The procedure is performed in a specialized residential treatment facility.
Personnel
- Mental health therapists (counselors, psychologists)
- Support staff (assistant counselors, residential coordinators)
- Medical professionals for medication management (if needed)
- Administrative staff
Risks and Complications
Common Risks:
- Adjustment period discomfort
- Potential for relapse or withdrawal symptoms
Rare Risks:
- Adverse reaction to any prescribed medications
- Interpersonal conflicts within the residential setting
Management of Complications:
- Continuous monitoring and support
- Adjustment of treatment plans
- Referral to higher levels of care if necessary
Benefits
Expected Benefits:
- Stabilization and improvement in behavioral health conditions
- Acquiring new coping mechanisms and life skills
- Better long-term prognosis and quality of life
Timeframe for Benefits:
- Continuous improvement is expected over the course of the residential stay, with long-term benefits realized post-treatment.
Recovery
Post-Procedure Care:
- Follow-up appointments with outpatient providers
- Possible continuing care recommendations (e.g., halfway houses, outpatient therapy)
Recovery Time:
- Varies by individual, but support is ongoing even after discharge to ensure sustained recovery.
Restrictions:
- Participation in structured daily routines
- Adherence to therapy schedules and guidelines
Alternatives
Other Treatment Options:
- Outpatient therapy or counseling
- Short-term residential treatment
- Day programs or partial hospitalization programs
Pros and Cons:
- Outpatient therapy may offer more flexibility but less intensive support
- Short-term residential provides stabilization but may not be sufficient for chronic issues
- Day programs offer structured support but lack the immersive environment of residential care
Patient Experience
During the Procedure:
- Patients may experience an adjustment period with varying levels of comfort
- Structured daily routines can provide stability and support
After the Procedure:
- Continued support and aftercare for long-term maintenance of recovery
- Possible emotional and psychological growth, leading to improved coping strategies
Pain Management and Comfort Measures:
- Regular therapeutic support to address discomfort and challenges
- Access to recreational and relaxation activities