Alliance Rates for BH Services – State and Medicaid Services

This communication has been revised for April 1 Medicaid Direct launch. This communication was originally published on January 18, 2023.

Medicaid COVID Rates
Effective April 1, 2023, the remaining COVID rates currently in place will become permanent rates:

The COVID rates for the following services will terminate April 30, 2023:

State COVID Rates

COVID rates will remain in effect through June 30, 2023.

Taxonomy Verification

In preparation for Medicaid Direct and the Tailored Plan, Alliance will reimburse services provided according to the taxonomy billed for Medicaid and state services.

Under the Tailored Plan, Alliance will only be able to maintain separate rates for behavioral health services when there is an applicable psychiatric taxonomy to apply in our claims system. Please take note of the changes being implemented.

Physicians

Effective April 1, 2023, Alliance will pay a specific behavioral health rate when one of the taxonomies below is billed on the claim.  This applies to only a subset of services as noted on our fee schedule.  If another taxonomy is billed, the claim will deny. Effective October 1, 2023, the standard Medicaid Physician rate will pay when a non-behavioral health taxonomy is billed. Please note that if the taxonomy being billed is NOT registered in NCTracks for your provider, the claim will deny.

Physician Assistants

Effective April 1, 2023, Alliance will be migrating to the Medicaid Physician Assistant fee schedule. There is not a separate psychiatric taxonomy for Physician Assistants. As such, Alliance is unable to maintain specific behavioral rates.

The Medicaid rates posted to the NC DHB website effective April 1, 2023, will be implemented in the Alliance Claims System (ACS). Ongoing updates will follow the NC DHB updates.

Below are examples of rate changes that could impact your organization. Differences in red indicate a lower rate than the current Alliance rate.

Nurse Practitioners

Effective April 1, 2023, Alliance will pay a specific behavioral health rate when one of the taxonomies below is billed on the claim. If another taxonomy is billed, the claim will deny. Effective October 1, 2023, the standard Medicaid Nurse Practitioner rate will pay when a non-behavioral health taxonomy is billed. Please note that if the taxonomy being billed is NOT registered in NCTracks for your provider, the claim will deny.

Licensed Psychologist/Licensed Psychological Associate

Alliance currently maintains separate rates for these two clinical levels. As both levels use the same taxonomy, 103T00000X, Alliance will be combining those rates into one rate equal to the current LP rates. Please look for an updated fee schedule coming soon to reflect the April 1, 2023 revised LP/LPA rates.