MST Services' position on Medicaid funding for MST programs sums up our current “lessons learned” regarding the strengths and challenges of using Medicaid funding to support MST implementation. Medicaid funding has emerged as an important facilitator in the growth of MST and it is playing a critical role in the financial sustainability of many MST programs across the United States. However, we caution stakeholders against viewing Medicaid as a “silver bullet” solution to their funding troubles due to the potential challenges of using Medicaid funds to support the model-adherent implementation of MST. For the full “Position Statement on Medicaid Funding for MST Programs” click here.
The standards and service descriptions for Medicaid or other funding sources for MST of various states are summarized below. Information on each state's MST standards is provided as well as an assessment of how consistent these standards are with MST. Suggested elements to be included in an MST Medicaid Standard are presented in the MST Preferred Service Description document. For an example of how states can be rated using this preferred service description, review our Sample MST Preferred Service Description Rating Form.
While some states use the current Multisystemic Therapy H2033 HCPCS code (see page eight) for Medicaid billing, many states have created MST funding mechanisms under other HCPCS codes or have chosen to use pre-existing Medicaid codes such as those for “Intensive In-home Services”. In the table below, rating information is provided on how consistent each state's standards are with the MST evidence base.
These state Medicaid standards are rated by placing them in one of four categories (i.e., Highly Consistent, Consistent, Mostly Consistent, or Minimally Consistent) by comparing them to the list of recommended program practices and requirements presented in the MST Preferred Service Description document. These recommended program practices and requirements have been developed to replicate the characteristics of clinicians, training, clinical supervision, consultation, monitoring and program support provided in the successful clinical trials of MST and have been refined through extensive experience with MST program replications throughout the United States and in growing a number of sites internationally.
The goals of MST programs include providing clinically effective, family-based services with high levels of provider accountability for outcome. Thus, the functional mission and current service array of the MST host agency must be examined for compatibility with the MST treatment approach. The Success of MST depends on the provision and proper management of these necessary resources.
For those individuals interested in assistance with RFP development, please refer to Draft MST RFP Template. This file is helpful in writing an RFP as it contains the elements that should be included in the RFP for MST.
For technical assistance in developing funding or Medicaid standards for MST, please contact Melanie Duncan, Project Manager, at melanie.duncan@mstservices.com. For other technical assistance in the planning and implementation of financing and management of other human services and mental health treatments not specific to MST, contact John Morris (jmorris@tacinc.org) from the Technical Assistance Collaborative (TAC) at www.tacinc.org.
| STATE / COUNTY | SERVICE DESCRIPTION MEDICAID / FUNDING STANDARD | LEVEL OF CONSISTENCY W/ MST EVIDENCE BASE | ADDITIONAL INFORMATION / COMMENTS |
|---|---|---|---|
| Alabama | No licensed MST teams operating | N/A | N/A |
| Alaska | No licensed MST teams operating | N/A | N/A |
| Arizona | The accepted definition of MST is: | Review under development | |
| Arkansas | N/A | N/A | N/A |
| California | Copy of standard not obtained Outpatient Mental Health Services - Medi-Cal | N/A | |
| Colorado | No MST standard has been identified | N/A | |
| Connecticut | CT Draft MST Medicaid Standard | Review under development | |
| Delaware | Copy of standard not obtained | N/A | |
| District of Columbia | Copy of standard not obtained Community Based Intervention (CBI) Level I | N/A | |
| Florida | N/A | N/A | N/A |
| Georgia | N/A | N/A | N/A |
| Hawaii | HI MST Medicaid Standard | Mostly Consistent - While this standard is not specific to MST it is mostly consistent with the MST evidence base. Fortunately the HI MST system has practice standards that demand adherence to the MST model in areas where this standard is silent (e.g. QA, staff training, etc.). HI - MST Service Description Rating | |
| Idaho | No licensed MST teams operating | N/A | N/A |
| Illinois | N/A | N/A | N/A |
| Indiana | No licensed MST teams operating | N/A | N/A |
| Iowa | No licensed MST teams operating | N/A | N/A |
| Kansas | No licensed MST teams operating | N/A | N/A |
| Kentucky | No licensed MST teams operating | N/A | N/A |
| Louisiana | LA Medicaid PFII (Parent/Family Intervention Intensive) Standard | This standard is not specific to MST and has not been reviewed. | No MST Programs in Louisiana are currently funded by Medicaid. In order to bill Medicaid in Louisiana for home-based services, it is required that mental health agencies be certified as Mental Health Rehab providers. Currently, there is a moratorium on certifying agencies. When this moratorium is lifted and if any mental health agencies providing MST are certified as Mental Health Rehab providers, the PFII (Parent/Family Intervention Intensive) service description may be reviewed for its compatibility with MST Standards. |
| Maine | Home-Based Mental Health Services Definition | This standard is not specific to MST and has not been reviewed. | |
| Maryland | N/A | N/A | N/A |
| Massachusetts | No licensed MST teams operating | N/A | N/A |
| Michigan | N/A | N/A | N/A |
| Minnesota | N/A | N/A | N/A |
| Mississippi | N/A | N/A | N/A |
| Missouri | No licensed MST teams operating | N/A | |
| Montana | No licensed MST teams operating | N/A | N/A |
| Nebraska | NE MST Medicaid Standard Multi-Systemic Therapy Intensive Outpatient Program | This standard has not been reviewed. | |
| Nevada | No licensed MST teams operating | N/A | N/A |
| New Hampshire | No licensed MST teams operating | N/A | N/A |
| New Jersey | N/A | N/A | N/A |
| New Mexico | NM MST Medicaid Standard Federal H2033 Multisystemic Therapy (MST) code | Highly Consistent - This standard is highly consistent with the MST evidence base although it lacks specifying the significant exclusionary criteria for standard MST. NM - MST Service Description Rating | |
| New York | N/A | N/A | N/A |
| North Carolina | NC MST Medicaid Standard Federal H2033 Multisystemic Therapy (MST) code NC LME Standards | Consistent - This standard is consistent with the MST evidence base. While this standard is intended to fund the use of MST within the evidence-based referral range of youth 12-17 years old, it was written with a broader age range of 7- 17 to enable the formal evaluation of using MST with youth down to an age of 7 years old in hopes of facilitating further development of the MST evidence base. NC - MST Service Description Rating |
Provider organizations must demonstrate that they meet these standards by being endorsed by the LME. |
| North Dakota | No licensed MST teams operating | N/A | N/A |
| Ohio | OH Intensive Home Based Treatment Service Description Intensive Home Based Treatment (IHBT) Service | This standard is not specific to MST and has not been reviewed. | The Intensive Home-Based Treatment rule is inclusive of MST. |
| Oklahoma | N/A | N/A | N/A |
| Oregon | N/A | N/A | N/A |
| Pennsylvania | PA Draft MST Medicaid Standard | Highly Consistent - This standard is highly consistent with the MST evidence base although it fails to specify how staff training and program QA are to be addressed, or the significant exclusionary criteria for standard MST. PA - MST Service Description Rating | N/A |
| Rhode Island | N/A | N/A | N/A |
| South Carolina | SC Mental Health Services Not Otherwise Specified (MHSNOS) Service Description | Mostly Consistent - While this standard is not specific to MST it is mostly consistent with the MST evidence base. Fortunately the SC MST system has practice standards that demand adherence to the MST model in areas where this standard is silent (e.g. QA, staff training, etc.). SC - MHS-NOH Service Description Rating | N/A |
| South Dakota | No licensed MST teams operating | N/A | N/A |
| Tennessee | No MST standard has been identified | N/A | N/A |
| Texas | N/A | N/A | N/A |
| Utah | No licensed MST teams operating | N/A | N/A |
| Vermont | No licensed MST teams operating | N/A | N/A |
| Virginia | N/A | N/A | N/A |
| Washington | N/A | N/A | N/A |
| West Virginia | No licensed MST teams operating | N/A | N/A |
| Wisconsin | No licensed MST teams operating | N/A | N/A |
| Wyoming | N/A | N/A | N/A |