B7 Crisis Services Provider

Revised 01/31/2025

Policy

Provides an alternative to hospitalization for adults in crisis who have a mental illness, substance abuse disorder, or intellectual or developmental disability. Services, including short-term intensive evaluation and treatment intervention, are provided in a full-time residential facility.

Requirement	Yes/No
Risk Level	Limited
Enrollment Fee	Yes
Fingerprint Clearance Background Check (FCBC)	No
National Provider Identifier (NPI)	Yes
Site Visit	No
Electronic Funds Transfer (EFT)	Yes

Enrollment and Categories of Service (COS)

Enrollment type: Facility/Agency/Organization (FAO)
Reimbursement type: 02 Non-Contracted Fee for Service (FFS)

Categories of Service (COS)	License/Certification for COS	COS Mandatory or Optional
47 Mental Health	Arizona Department of Health Services (ADHS)/Behavioral Health Services (BHS) Level I Facility The Joint Commission (TJC), Council on Accreditation (COA) or Commission on Accreditation of Rehabilitation Facilities (CARF) Accreditation	Mandatory
31 Non-Emergency Medical Transportation (NEMT)	Vehicle Insurance	Optional

Legal Authorities

42 CFR 455.12
AAC R9-10-1016