DHS 107.13(3m)(d)2.2. Time spent in the AODA day treatment setting by affected family members of the recipient; DHS 107.13(3m)(d)3.3. AODA day treatment services which are primarily recreation-oriented or which are provided in non-medically supervised settings. These include but are not limited to sports activities, exercise groups, and activities such as crafts, leisure time, social hours, trips to community activities and tours; DHS 107.13(3m)(d)4.4. Services provided to an AODA day treatment recipient which are primarily social or only educational in nature. Educational sessions are covered as long as these sessions are part of an overall treatment program and include group processing of the information provided; DHS 107.13(3m)(d)5.5. Prevention or education programs provided as an outreach service or as case-finding; and DHS 107.13(4)(4) Mental health day treatment or day hospital services. DHS 107.13(4)(a)(a) Covered services. Day treatment or day hospital services are covered services when prescribed by a physician, when provided by a provider who meets the requirements of s. DHS 105.24, and when the following conditions are met: DHS 107.13(4)(a)1.1. Before becoming involved in a day treatment program, the recipient is evaluated through the use of the functional assessment scale provided by the department to determine the medical necessity for day treatment and the person’s ability to benefit from it; DHS 107.13(4)(a)2.2. The supervising psychiatrist approves, signs and dates a written treatment plan for each recipient and reviews and signs the plan no less frequently than once every 60 days. The treatment plan shall be based on the initial evaluation and shall include the individual goals, the treatment modalities including identification of the specific group or groups to be used to achieve these goals and the expected outcome of treatment; DHS 107.13(4)(a)3.3. Up to 90 hours of day treatment services in a calendar year may be reimbursed without prior authorization. Psychotherapy services or occupational therapy services provided as component parts of a person’s day treatment package may not be billed separately, but shall be billed and reimbursed as part of the day treatment program; DHS 107.13(4)(a)4.4. Day treatment or day hospital services provided to recipients with inpatient status in a hospital are limited to 20 hours per inpatient admission and shall only be available to patients scheduled for discharge to prepare them for discharge; DHS 107.13(4)(a)5.5. Reimbursement is not made for day treatment services provided in excess of 5 hours in any day or in excess of 120 hours in any month; DHS 107.13(4)(a)6.6. Day treatment services are covered only for the chronically mentally ill and acutely mentally ill who have a need for day treatment and an ability to benefit from the service, as measured by the functional assessment scale provided by the department; and DHS 107.13(4)(a)7.7. Billing for day treatment is submitted by the provider. Day treatment services shall be billed as such, and not as psychotherapy, occupational therapy or any other service modality. DHS 107.13(4)(a)8.8. The groups shall be led by a qualified professional staff member, as defined under s. DHS 105.24 (1) (b) 4. a., and the staff member shall be present throughout the group sessions and shall perform or direct the service. DHS 107.13(4)(b)1.1. Providers shall obtain authorization from the department before providing the following services, as a condition for coverage of these services: DHS 107.13(4)(b)1.a.a. Day treatment services provided beyond 90 hours of service in a calendar year; DHS 107.13(4)(b)1.b.b. All day treatment or day hospital services provided to recipients with inpatient status in a nursing home. Only those patients scheduled for discharge are eligible for day treatment. No more than 40 hours of service in a calendar year may be authorized for a recipient residing in a nursing home; DHS 107.13(4)(b)1.c.c. All day treatment services provided to recipients who are concurrently receiving psychotherapy, occupational therapy or AODA services; DHS 107.13(4)(b)1.d.d. All day treatment services in excess of 90 hours provided to recipients who are diagnosed as acutely mentally ill. DHS 107.13(4)(b)2.b.b. The name, address, and provider number of the provider of the service and of the billing provider; DHS 107.13(4)(b)2.e.e. A statement of the estimated additional dates of service necessary and total cost; and