Services for Individuals age 65 or Older in an Institution for Mental Diseases

This service is often referred to as "IMD over 65". It is an option that most states have chosen to offer in their Medicaid program. Services may be provided either in a hospital or in a nursing facility that is considered an institution for mental diseases (IMD), meaning that the facility meets the federal and state requirements of a hospital or nursing facility, but is also considered an IMD.

Ordinarily states are responsible for the costs of IMDs; the federal Medicaid program specifically excludes reimbursement for residents of an IMD. The two exceptions are individuals over age 65 who receive this service, and younger individuals who receive the psych under 21 service. Individuals in either type of IMD who are between the ages of 22 and 64 may not receive Medicaid reimbursement.

Individuals applying to or receiving this service in a nursing facility are subject to Preadmission Screening and Resident Review (PASRR).