Initial Treatment Plan 1-15-05

Individual Treatment Plan (Review) – H0032 TS . For Substance Abuse Treatment – T1007 TS . Client Identifying Information Effective Date: Name: (LAST, First Middle) Gender: SSN: Date of Birth: Medicaid #: DSM. Current Diagnosis. Primary focus of treatment listed first – if primary diagnosis is substance abuse related, use billing code T1007. ................
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