Access to Care Policy

SUD Specialty Group – CA, Mental Health Specialty Group, P.A., Mental Health Specialty Group NJ, PC, and Mental Health Specialty Group KS, P.A. (collectively, “Group”) contracts with Path, CCM, Inc. d/b/a Rula (“Rula”) for management and administrative support services. Each entity within the Group and Rula may be referenced herein as a Company and, collectively, as the Companies.

Policy Statement

This policy ensures that patients have access to care. Access to care is an important part of achieving better outcomes for patients.

Applicability:

This policy applies to all team members. For purposes of this policy, the Companies’ team members include individuals who would be considered part of the workforce, such as employees, independent contractors, and other persons whose work performance is under the direct purview of the Companies’  business practices. 

Definitions

Access to Care: is defined as a patient’s ability to see a qualified provider within a reasonable amount of time. 

Routine care: services provided to a patient that do not require urgent or emergency care. These are considered “regularly” scheduled appointments. 

Urgent care: services provided to a patient when a behavioral health symptom or condition requires prompt attention. This need is perceived by a patient as serious but not life threatening, it disrupts normal activities of daily living (work, home or school), requires an assessment and/or intervention by a provider, and if necessary, treatment within 72 hours

Emergent care: services provided to a patient when behavioral health symptoms or condition(s) require immediate attention. Emergent or emergency care is considered life threatening if the symptoms or condition are not addressed immediately. 

Policy

1. Access to Care standards can vary by payer, state, regulatory and/or accrediting body. Rula team members should follow the guidance of this policy; however in cases where a shorter access to care standard is required, team members are expected to follow that shorter timeline. 

1. Patients will be offered an initial appointment within 14 business days of their request for access to mental health care. 

2. Patients will be offered an appointment as soon as reasonably possible after their request for an urgent behavioral health (non-life-threatening emergency) need, or directed to an appropriate service through Rula’s crisis line. 

3. Access to Emergency or After-Hours Care: patients are provided with information regarding the 988 Suicide and Crisis Lifeline, which provides 24/7, confidential support with trained crisis counselors, Rula’s crisis line via Protocol (877) 371-5488, and other emergency and crisis resources throughout treatment as needed. This information can be found 24/7 on Rula’s website and/or Help Center. Providers are expected to explain emergency or after-hours care arrangements with their patients during the first visit and relevant follow up visits. 

2. Urgent appointments shall be documented using the appropriate CPT code. Typically, urgent needs are not pre-scheduled appointments. Providers should select the appropriate “crisis” note type and the relevant code:

   1. 90839 is a stand-alone code not to be reported with psychotherapy or psychiatric diagnostic evaluation codes, the interactive complexity code, or any other psychiatric code on the same day. 

   2. Report 90839 for the first 30-74 minutes of an urgent service on a given date. For urgent needs lasting between 16-30 minutes, a 90832 may be appropriate to bill.

   3. 90840 is an add-on code that should be reported for each additional 30 minutes of the urgent service beyond the first 74 minutes. 

3. Rula, as part of the Quality Assurance Program and Plan, routinely monitors and evaluates Access to Care standards to ensure that patient needs can be met. 

Attachments: None

Updated December 10, 2025 15:36