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Medical Necessity

Medical necessity means providing services that fit your medical needs.  Learning about it can help you work with your mental health center to make choices about your mental health care.

For rehabilitation services, like Community Support, Psychosocial Rehabilitation (PSR), or Assertive Community Treatment (ACT), medical necessity has a special meaning.  These services must help you get back functions that have been interfered with by a mental illness or substance use disorder.  At times a mental illness may make it hard for you to remember the steps to take care of yourself or to get a job.  Rehabilitation services can help you learn and practice ways to overcome such negative effects of an illness. 

These services may help you gain skills, use resources, or obtain and use supports.  They can help you to modify your surroundings to make it easier to be successful in meeting your goals– as long as you need that help because of a mental illness or substance use disorder.

Medical necessity can help ensure that a service gives you or helps you find supports that you need.  It can also help ensure that a service does not get in the way of your ability to live, work, learn and participate fully in a life in the community.