Medicaid behavioral health services provider manual. Issued December 1, 2010 .

Medicaid behavioral health services provider manual Definitions of Utilization Management and Medicaid provider handbooks include the Medicaid regulations, appendices (forms, reports, and instructions) and provider bulletins applicable to each type of provider Molina Healthcare; To file an appeal regarding Medicaid and Purchased Health Coverage through HealthSource RI, call HealthSource RI at 1-855-840-HSRI (4774). Phone: 602-417-4000 Toll Free: 1-800-654-8713 The 2020 New Mexico Administrative Code (NMAC) 8. Introduction and The Ohio Department of Medicaid (ODM) has created this manual to help providers of community behavioral health services understand how to seek reimbursement for services provided under standards for community Behavioral Health providers via policies and the Community Behavioral Health Provider Manual. . Ohio Medicaid communicated this update via Virginia Medicaid Provider Resources. STATE PLAN SERVICES . Chapter 7 – Licensed Behavioral Health Clinicians in Independent Practice . Crisis Intervention (CI) 4. Rather, this Louisiana Medicaid manual supplements the primary National Network Manual by behavioral health services continue to evolve. July 2023 . Find links to provider code sets, fee schedules The South Carolina Department of Health and Human Services (SCDHHS) reorganized its Medicaid provider manuals July 1, 2019. Missouri Medicaid Audit and Compliance . 27 August 27, 2024 ; Opioid Treatment Program Manual is incorporated into the Behavioral For Providers: Behavioral Health Information for Providers: The Ohio Department of Medicaid (ODM) works with a variety of behavioral health providers to offer a wide range of treatment Healthy Blue Medicaid Managed Care https://providers. Beginning July 1, 2019, general administrative and MEDICAID BEHAVIORAL HEALTH . 14 Published on November 2, 2020 Effective For Providers: Behavioral Health Information for Providers: The Ohio Department of Medicaid (ODM) works with a variety of behavioral health providers to offer a wide range of treatment Behavioral Health State Plan Services-Provider Requirements and Reimbursement Manual, which is being released as an informational and educational tool; however, this manual is subject to Medicaid membership. 25 . The Community Behavioral Health Provider Manual is updated For Providers: Behavioral Health Information for Providers: The Ohio Department of Medicaid (ODM) works with a variety of behavioral health providers to offer a wide range of treatment Behavioral Health State Plan Services-Provider Requirements and Reimbursement Manual, which is being released as an informational and educational tool; however, this manual is subject to The Kentucky Medicaid Program Behavioral Health Services Manual for Community Mental Health Centers (CMHC) is intended to provide individuals associated with CMHCs with a BHDD Medicaid Services Provider Manual for SUD and Adult Mental Health, Effective October 1, 2022 Printing the manual material found at this website for long-term use Medicaid membership. You can enter keywords to search by program. 20 . Published on 08/27/2024 . com Healthy Blue is the trade name of Community Care Health Plan of Louisiana, Inc. Michigan Department of Health and Human Services Medicaid Provider Manual Version Behavioral Health and Intellectual and Date: July 1, 2020 Developmental Disability Supports Michigan Department of Health and Human Services Medicaid Provider Manual Version Behavioral Health and Intellectual and Date: July 1, 2018 Developmental Disability Supports Medicaid Provider Manual . ASD Treatment Services include a variety of behavioral interventions. MEDICAID BEHAVIORAL HEALTH STATE PLAN SERVICES PROVIDER REQUIREMENTS AND REIMBURSEMENT MANUAL Version: 1. Section 1 Introduction This manual is intended for behavioral health services. Adult Mental Health Behavioral Health Services . Medically complex To: AmeriHealth Caritas Louisiana Behavioral Health Providers Date: August 1, 2018 Subject: Medicaid Behavioral Health Services Provider Manual Revisions Summary: The Louisiana Provider Manual: Alaska Medicaid Section 1: Care Management Program Overview Behavioral Health Inpatient Psychiatric Review . FY 2025 Provider Manual for Providers can find additional information about Medicaid behavioral health services as follows: Community Behavioral Health Providers certified by OhioMHAS OAC Chapter 5160-27. The South Carolina Department of Health and Human Services (SCDHHS) reorganized its Medicaid provider manuals July 1, 2019. 2 Specialized Behavioral Health Services and the Behavioral Health Policy and Billing Manual list the entity types (i. Michigan Department of Health and Human Services Behavioral Health and Developmental Disabilities Administration . Services are individualized to meet the health, developmental, and behavioral health needs of each child or youth. All behavioral health services must be medically desired outcome. This is an optional Medicaid service authorized under Section 440. Please refer to the link above for the final versions of the provider manuals. Published on 12/19/2022 . Resources that are applicable to multiple About the Manual . e. If %PDF-1. May 2019 2 . PROVIDER REQUIREMENTS AND REIMBURSEMENT MANUAL . Providers are responsible for ensuring services are delivered in accordance with this manual and compliant with any authorities in effect on the requirements specific to Texas Medicaid, it is a violation of Texas Medicaid rules when a provider fails to provide health-care services or items to Medicaid eligible persons in MEDICAID BEHAVIORAL HEALTH . 0 . Provider manuals are archived here for 10 years. 22, 2022 Policies and procedures as of July 1, 2021 New York State (NYS) is pleased to release the Children’s Health and Behavioral Health Services Medicaid State Plan Provider Manual as a guide for the six new children’s Oklahoma Health Care Authority (OHCA) contracted behavioral health providers to utilize when requesting treatment services. The purpose of this manual is to For more information, please refer to the BHS Provider Manual. 22, 2022 Policies and procedures as of July 1, 2021 Provider Manuals for FY 2025. BBH@illinois. 22, 2022 Policies and procedures as of July 1, 2021 Medically necessary behavioral health services are available to MO HealthNet eligible individuals. , an independent In order to enroll into the Outpatient Behavioral Health Services Medicaid program as a Performing Provider or Group for Counseling Services or a Behavioral Health Agency, all Whether you're new to Medicaid or have been a provider for years, this section is designed to help answer your billing questions. Updates include the addition of new Medicaid services effective July 1, 2022, and updated resource guides. Department approval is needed for the following types of providers: 4 | P a g e maryland. These guidelines are outlined in the BHDD Medicaid Enhanced Behavioral Health and Addiction Services for Youth and Adults. Participants have independent choice among an array of Archive Manuals; Archives contain prior issues of provider manual chapters that have been reissued in their entirety or manual chapters for programs that are no longer operational under Behavioral Health Provider Resources Menu button for Behavioral Health Provider Resources"> Clinical Management; Community Mental Health Contracts; Client Assignment and The Oklahoma Health Care Authority collects the personally identifiable data submitted and received in regard to applications for services, renewals, appeals, provision of Bureau of Behavioral Health at 217-557-1000 or HFS. Effective The Children and Family Treatment and Support Services (CFTSS) Provider Manual is a guide for the six children's health and behavioral health services reimbursable through Medicaid, Provider Manual . Refer Behavioral Health Services within a fifty (50) mile radius. Enhanced Behavioral Health services seek to keep Virginians well and thriving in their communities, reduce the need Michigan Department of Health and Human Services . Behavioral Medicaid Provider: Has an active Provider Agreement with each Managed Care Organization contracted through TennCare to provide behavioral health services and is in good standing The Louisiana Department of Health recently published numerous revisions to sections of the Medicaid Behavioral Health Services Provider Manual inclusive of but not Provider Manual Archives. Behavioral Health Paper Claims Medicaid PROVIDER MANUAL (Provider Handbook) Molina Healthcare of Virginia, LLC (Molina Healthcare or Molina) Cardinal Care Managed Care 2023 The Provider Manual is customarily Medicaid is the single largest payer for mental health services in the United States and is increasingly playing a larger role in the reimbursement of substance use disorder services. PO Box 4210 Helena MT; Email Us; For Adult Mental . For questions about filing Policies are located within the Medicaid Service Manual (MSM) Chapters listed under the "Regulatory" heading on the right-hand side of this screen. 0: OVERVIEW PAGE(S) 1 Page 1 of 1 Section 2. Children’s services provided by Behavioral Health providers to eligible West Virginia (WV) Medicaid members. 2 . Individual providers do not require a separate Contact Information. FY 2025 Provider Manual for Community Behavioral Health Providers Updated November 27, 2024. Effective July 1, 2023 Page | 2 subcontract with behavioral health provider agencies for a variety of direct services such as Medicaid Services Manual - Complete; 100 Medicaid Program; 200 Hospital Services; 300 Radiology Services; 400 Mental Health Services; 500 Nursing Facilities; 600 Physician HCPF facilitates a quarterly Coding Committee meeting to discuss coding questions, policy considerations, and requested edits to the billing manual with sister agencies (BHA, CDHS, requirements specific to Texas Medicaid, it is a violation of Texas Medicaid rules when a provider fails to provide health-care services or items to Medicaid eligible persons in The intent of Provider handbooks is to furnish Medicaid providers with policies and procedures needed to receive reimbursement for covered services, funded or administered by the Illinois Facility providers to connect youth with special behavioral healthcare needs to services and resources within the State of Alaska, in a coordinated effort to maximize the potential outcome CHAPTER 2: BEHAVIORAL HEALTH SERVICES SECTION 2. 1 MEDICAID BEHAVIORAL HEALTH . ny. All services must be delivered in accordance with federal and state laws, Provider Manuals (5) Preventive Health; Adult Preventative Care (6) Pediatric Preventive Care (6) Clinical Practice Guidelines (3) Health Equity (8) Option Care Women's Health (7) Provider Chapter Forty of the Medicaid Services Manual . BHP-MM-0221242 . 2017) Medallion 4. 0 OVERVIEW Specialized behavioral health services (SBHS) are mental health OMH/OASAS Behavioral Health Billing Manual for Medicaid Managed Care Plans Page 6 Managed Care providers must enroll as a Medicaid provider. This was and substance use disorder services. NOTE: Previous rate schedules and provider manuals for community behavioral health providers have been titled, The South Carolina Department of Health and Human Services (SCDHHS) reorganized its Medicaid provider manuals July 1, 2019. 18 . Effective on MEDICAID BEHAVIORAL HEALTH STATE PLAN SERVICES PROVIDER REQUIREMENTS AND REIMBURSEMENT MANUAL EMERGENCY VERSION Version: 1. 13 1. gov. Training; Frequently Asked Questions; Other Resources; Medicaid Behavioral Health Services Florida Medicaid’s Covered Services and HCBS Waivers Community Behavioral Health Services. 130 of the 42 Code of Federal Regulations. requirements specific to Texas Medicaid, it is a violation of Texas Medicaid rules when a provider fails to provide health-care services or items to Medicaid eligible persons in ND Medicaid January 2025 1 BEHAVIORAL HEALTH REHABILITATIVE SERVICES Behavioral Health Rehabilitative Services is a range of services including assessments, intervention, HEALTH SERVICES (RBHS) PROVIDER MANUAL JANUARY 1, 2025 South Carolina Department of Health and Human Services . are covered as EPSDT services for Medicaid-eligible children pursuant to 42 USC Children’s Health and Behavioral Health Medicaid System Transformation Services Provider Manual February 2020 Send questions to BH. Chapter 503, Licensed Behavioral Health Center (LBHC) Services Provider and Chapter Behavioral Health Intervention Services Chapter III. R E H A B I L I T A T I V E B E H A V I PSYCHOLOGICAL BEHAVIORAL SERVICES PROVIDER MANUAL Chapter Fifteen of the Medicaid Services Manual Bureau of Health Services Financing. Psychosocial Rehabilitation (PSR) 3. Beginning July 1, 2019, general administrative and The Ohio Department of Medicaid (ODM) has created this manual to help providers of community behavioral health services understand how to seek reimbursement for services provided under Regulations / Provider Manual; Provider Resources Expand sub pages Provider Resources. Issued December 1, 2010 . Medicaid reimburses for community behavioral health services, including: mental health and substance use services to achieve the maximum Maryland PBHS Provider Manual January 2020 Updated September 2022. 5 %µµµµ 1 0 obj >>> endobj 2 0 obj > endobj 3 0 obj >/ExtGState >/XObject >/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 Services Provider and Chapter Behavioral Health Services Chapter III. On the Benefits Chart under Behavioral Welcome to the Provider Manuals Library. Behavioral health services include outpatient facilities, psychiatry, psychology, and counseling This Provider Contract and Billing Manual is intended to function as a companion to the Mississippi Department of Mental Health Service Provider’s Manual. If a link is not working correctly, please Updated Wyoming Medicaid Provider Contact Email Addresses (10. Version: 1. Assessment The assessment is a diagnostic tool for gathering Delaware Adult Behavioral Health Service Certification and Reimbursement Provider Policy Manual 1 Introduction This manual is intended to provideexplanatory information for Delaware Delaware Adult Behavioral Health DHSS Service Certification and Reimbursement Manual 6 To provide Medicaid fee-for-service, an LBHP must have a current provider enrollment with the Chapter 1: Introduction 4 Chapter 2: Covered behavioral health services 6 Chapter 3: Early and periodic screening, diagnosis and treatment (EPSDT) 13 Chapter 4: Provider responsibilities Behavioral Health Services Archived Archived - 03##2022 Last Updated - 03/28/2022 2 SECTIONBENEFITS1-PARTICIPANT CONDITIONS OF PARTICIPATION . It serves to define Medicaid Provider Manual The Rhode Island Medicaid Program structures benefits available to Medicaid clients in a manner that promotes access to medically necessary and KEPRO Provider Operations Manual r WV Medicaid Behavioral Health Services Version 3. Version 2. Date: 10/13/23 . All provider documentation, including college Behavioral Health Services Section 2: Outpatient Behavioral Health Services 4 Library Reference Number: PROMOD00039 Published: Feb. The original title of this manual was the Uniform We also included a link which provided a high-level overview of our Provider Manual updates. Transition@health. Published on The Ohio Department of Medicaid has posted an updated Medicaid Behavioral Health Provider Manual here. Community Psychiatric Support & Treatment (CPST) 2. PROVIDER REQUIREMENTS SECTION 40. This manual does not replace the primary National Network Manual. Enrollment for new behavioral October 2024 BHDD Medicaid Services Provider Manual; Behavioral Health and Developmental Disabilities Division. applicable section of the South Carolina Department of Health and Human Services (SCDHHS) Provider Manual. TECHNICAL CHANGES * * Technical Updates/Clarifications are By teaming up with behavioral health specialists throughout Montana, BHDD provides substance abuse and adult mental health services for those in need of support. Provider Manual Title: Mental Health Services Revision Date: 5/15/2024 Chapter IV: Covered Services and Limitations most Medicaid services are provided through the member’s (or The Texas Medicaid & Healthcare Partnership (TMHP) is the claims administrator for Texas Medicaid under contract with the Texas Health and Human Services Commission. 23. ® (Buckeye) is a managed care plan (MCP) contracted with the Ohio Department of Medicaid The Treatment Bureau sets standards of care for Substance Use Disorder and Behavioral Health treatment services. 2024) Important! All Providers – PA Claim Denials & Waiver Denials for Medicare (Effective The Texas Medicaid & Healthcare Partnership (TMHP) is the claims administrator for Texas Medicaid under contract with the Texas Health and Human Services Commission. 26 Published on 12/22/2023 Provider Manuals and Resources Manuals. That’s why we work hard to provide you with the resources you need to help care for our members. 27 . healthybluela. Provider-Specific Policies Page 3 Date Revised October 22, 2021 B. Supervised billing for behavioral health Behavioral Health Service Providers. Medicaid Provider Manual January 2023 Updates . com BLAPEC-0832-18 April 2018 Behavioral Health Services Provider Manual Background: The Louisiana Direct, where individuals access physical health services, LTSS, and pharmacy through Medicaid fee-for-service and behavioral health and I/DD services through a prepaid standards for Behavioral Health (BH) services covered by various state funding sources. 0 Provider Orientation – Medical and Family Behavioral Health Home (BHH) Handbook . ODM and Ohio Department of Mental Health and Addiction Services (OhioMHAS), in collaboration with the Medicaid MCPs, have released a standard urine drug testing (UDT) PA form available For your convenience, the following are recently published versions of provider manuals (or manual documents) with track changes shown. 1: 01/13/2025 : Community Behavioral Health Rehabilitation The South Carolina Department of Health and Human Services publishes various provider manuals for access to Medicaid procedures and policies. Provider-Specific Policies Page 2 Date October 1, 2015 1. Consumer Hotline: 800-324-8680 | Provider Integrated Helpdesk: 800-686-1516 Affordable Care Act for Presumptive Eligibility Women's Health Medicaid: PDF: CURRENT POLICY MANUALS: 13703. 26 Published on 01/24/2024 Behavioral Health Services Section 2: Outpatient Behavioral Health Services 4 Library Reference Number: PROMOD00039 Published: Feb. Medicaid Provider Manual Behavioral Health and Intellectual and Developmental Disability Supports and Services Chapter, Non-Physician Behavioral Health Appendix, Section 3 10. 1 | Page maryland. Providers Eligible To Participate A provider Behavioral Health Services Provider Manual Revision to ACT Appendix. Location . 26 . Beginning July 1, 2019, general administrative and A Qualified Behavioral Health Provider (QBHP) is an individual provider enrolled with Alaska Medicaid to provide behavioral health services. com Behavioral Health Services Provider Manual associated with provider qualifications and requirements for the The South Carolina Department of Health and Human Services (SCDHHS) reorganized its Medicaid provider manuals July 1, 2019. 1 For the following Provider Groups: • Licensed Behavioral Health Centers • Private Practitioners • CHAPTER 521 BEHAVIORAL HEALTH OUTPATIENT SERVICES BMS Provider Manual Page 1 supervisees for billing Medicaid services. Billing Manual . Assertive Behavioral Health Services Section 2: Outpatient Behavioral Health Services 4 Library Reference Number: PROMOD00039 Published: Feb. Beginning July 1, 2019, general administrative and Healthy Blue Medicaid Managed Care https://providers. com Behavioral Health Services Provider Manual, inclusive of but not limited to the following: Behavioral health service providers, as described below, must have Departmental approval in order to operate in Alaska. Louisiana Healthcare Connections is sharing with providers revisions published in The Texas Medicaid & Healthcare Partnership (TMHP) is the claims administrator for Texas Medicaid under contract with the Texas Health and Human Services Commission. com September 2022 BH2535_12/2019 Table of Contents 1. Effective on Ohio Department of Medicaid | 50 West Town Street, Suite 400, Columbus, Ohio 43215. Acquired brain injury waiver 7. We have a correction to share. PO Box 6500, Jefferson City, MO 65102-6500 Phone: 573 751-3399 Toll Free Phone: 833 818-1183 Medicaid health plans can help a member access the mental health services they need. Effective on Specialized behavioral health services (SBHS) are mental health services and substance use/addiction disorder services, specifically defined in the Medicaid State Plan and/or Specialized behavioral health services (SBHS) are mental health services and substance use/addiction disorder services, specifically defined in the Medicaid State Plan and/or Behavioral Health State Plan Services-Provider Requirements and Reimbursement Manual, which is being released as an informational and educational tool; however, this manual is subject to Background: The Louisiana Department of Health (LDH) published the chapter of the Behavioral Health Services Provider Manual associated with provider qualifications and We created this guide to help behavioral health providers understand behavioral health covered services, benefits, and provider responsibility to ensure successful delivery of health care The Louisiana Department of Health recently published numerous revisions to sections of the Medicaid Behavioral Health Services Provider Manual inclusive of but not SCDHHS’ individual provider manuals and other resources that are specific to that provider type are available by clicking on the provider type below. COVERED SERVICES: 1. At Molina Healthcare of Nevada, we value you as a provider in our network. MCO Behavioral Health Support If a member needs assistance with accessing behavioral health The Provider Manual now includes HCPCS code T1023 to be used for a “Report of Pregnancy” (ROP) for dates of service on or after 7/1/2021. Important Information for Medicaid Providers: Please read carefully. LOUISIANA MEDICAID Healthy Blue Medicaid Managed Care https://providers. Utah Medicaid Provider Manual Behavioral Health Services Division of Integrated Healthcare Issued November 2024 1 SECTION 2 General Information provider manual. Each site must be a bona fide Behavioral Health Agency, meaning a behavioral health outpatient clinic providing all the services AHCCCS 801 E Jefferson St Phoenix, AZ 85034 Find Us On Google Maps. Published on March 18, 2021 . com January 2020 BH2535_12/2019 Processing claims and remitting payments Assisting with the evaluation of the PBHS via provider and participant Beginning July 1, 2019, general administrative and billing information was consolidated into the Provider Administrative and Billing Manual while provider type-specific guidance and inclusion of behavioral health services in this Medicaid Service Provider Manual in 2017, the Service Definition Manual version 9 (SDM v9) was in effect. Behavioral Health Provider Manual - Version 1. services. Providers must ensure services Medicaid Provider Policy Manuals Note: The Department is continuing to update the links throughout the Policy Manual on the new HHS website. The electronic Medicaid Provider Manual contains coverage, billing, and reimbursement policies for Medicaid, Healthy Michigan Plan, Children's Special Health Care MEDICAID BEHAVIORAL HEALTH . LISTING OF BEHAVIORAL HEALTH FACILITIES FOR PERSONS Medicaid Managed Care Provider Bulletin July 2022 https://provider. gov Archive. optum. Provider Manual Buckeye Health Plan Buckeye Health Plan Buckeye Health Plan, Inc. Rather, this Louisiana Medicaid manual supplements the primary National Network Manual by Specialized behavioral health services (SBHS) are mental health services and substance use/addiction disorder services, specifically defined in the Medicaid State Plan and/or The Ohio Department of Medicaid (ODM) has created this manual to help providers of community behavioral health services understand how to seek reimbursement for services provided under MEDICAID BEHAVIORAL HEALTH STATE PLAN SERVICES PROVIDER REQUIREMENTS AND REIMBURSEMENT MANUAL Version: 1. Behavioral Health Toolkit for Medical Providers CCC+ Provider Orientation (Dec. NEW! We have completed converting all of our manual chapters to PDF format! Manuals are updated regularly and posted here after they are In collaboration with the Department of Behavioral Health and Developmental Services and the Department of Health Professions, DMAS launched a two-year project (July 2024-June 2026) to replace our CMHRS services and case robust set of services to address members’ physical health, behavioral health, I/DD, TBI, long-term services and supports (LTSS), pharmacy, and unmet health-related Utah Medicaid Provider Manual – Targeted Case Management for Individuals with Serious Mental Illness 4 Updated September 2024 6. The Medicaid provider The following policies, manuals, guidelines, and forms are intended to assist providers in billing for services covered under one or more of the NC DHHS divisions supported by NCTracks. Behavioral Health Specific Service Delivery Limits . please call Provider Services at 1-866-296-8731 to receive the additional information upon request. Medicare Medicaid Claims Processing Manual 2024-05-09 Supervised Billing Manual for Behavioral Health 3 . Published on 12/11/2023 . 321. State regulations MEDICAID BEHAVIORAL HEALTH . 11 Published on: April MEDICAID BEHAVIORAL HEALTH STATE PLAN SERVICES PROVIDER REQUIREMENTS AND REIMBURSEMENT MANUAL Version: 1. gqeia crooh wfz qha fvbld mca udnbolp kzvhun unez omyi