Clinical Coverage Policy 8A, Enhanced Mental Health and Substance Abuse Services was amended and promulgated on March 1, 2024, with a retroactive implementation date of Jan. 1, 2024.
The clinical coverage policies amended include:
Professional Treatment Services in Facility-Based Crisis Program (FBC)
FBC was amended and promulgated on March 1, 2024, with a retroactive implementation date of Jan. 1, 2024. The retroactive implementation date for the amendment aligns with FBC updates included in Medicaid Bulletin - NC Medicaid Behavioral Health Services Rate Increases published on Nov. 15, 2023. Units for utilization review at seven (7) days has been increased to 168 units and units for utilization review at eight (8) days has increased to 192 units. The allowable daily billing units increased from 16 hours to 24 hours in a 24-hour period. Language has been added to the policy to clarify that psychiatrists or physician extenders may bill separately for additional psychiatric evaluations (excluding the initial evaluation) and other therapeutic services when providing evaluation and management service.
Opioid Treatment Program
Opioid Treatment Program language was removed from Clinical Coverage Policy 8A, Enhanced Mental Health and Substance Abuse Services due to the implementation of the standalone policy, Clinical Coverage Policy 8A-9, Opioid Treatment Program. The standalone policy supersedes the Opioid Treatment Program policy previously included in CCP 8A.
Contact
NC Medicaid Contact Center: 888-245-0179