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Resources for Crime Victim Compensation Providers
Mental Health Treatment Guidelines
The Mental Health Treatment Guidelines (619 KB PDF / 3 min) are now available; for a printed or alternate format, e-mail Nolan Thompson at thoo235@LNI.wa.gov.
Get Help Downloading Files (files open in a new window).Reimbursement rates
The Crime Victims Compensation Program will reimburse mental health providers at L&I rates for effective dates of service May 1, 2006 and after. The Crime Victims Comp Mental Health Fee Schedule will be used to reimburse mental health providers.
All other provider types, with the exception of providers performing services related to sexual assault forensic examinations, will continue to be reimbursed at Medicaid rates until further notice. Visit the Medical Assistance Administration's web site (fortress.wa.gov) to find Medicaid reimbursement rates.
Forms
- Provider Account Application - Crime Victims Compensation Program.
- All Crime Victim Compensation forms.
Mental health reporting forms
- Form I: Initial Response and Assessment. Use when treatment is completed within six visits.
- Form II: Initial Response and Assessment. Authorization request for use when treatment will go beyond six visits.
- Form III: Progress Notes. Used to request preauthorization for payment of additional sessions.
- Form IV: Treatment Report. Used to request preauthorization for payment of additional sessions.
- Form V: Treatment Report. Used to request preauthorization for payment of additional sessions.
- Form VI: Termination Report. Used to inform L&I that you are no longer conducting treatment to the client.
