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Current Service Needs

Providers are needed in the areas defined on this page.

LIPs interested in any of the below service categories should complete and submit a provider application request and any additional information specifically requested.

Child Psychiatric Residential Treatment Facility (PRTF), Level IV, Level III, Level II group and family, and Facility-Based Crisis (FBC) Providers

North Carolina’s six Local Management Entities/Managed Care Organizations (LME/MCOs) launched the NC Child and Family Improvement Initiative on May 1, 2022, to create a statewide solution to the current pressing challenges of the service delivery system for youth in foster care.

Building on the early successes of the NC Child and Family Improvement Initiative, the LME/MCOs are moving forward to formalize a statewide network of child treatment providers to ensure that youth in the foster care system have continuity of care without delay when moving from one area of North Carolina to another.

When is this happening? Aug 1, 2022.

How is this affecting providers?
From August 1, 2022, through August 30, 2022, all LME/MCOs are offering an open enrollment period for child Psychiatric Residential Treatment Facility (PRTF), Level IV, Level III, Level II group and family, and Facility-Based Crisis (FBC) providers to ensure that children and adolescents have access to the services they need statewide. 

Provider Action Required:
If you are a child PRTF, Level IV, Level III, Level II group and family, or FBC provider and you want to join Alliance’s network, please submit the Provider Application Request.

Please note that your enrollment with NCTracks is a prerequisite. Data for the provider agency, including NPI, taxonomy, sites, and affiliated clinicians, must all be in NCTracks and successfully enrolled to continue to contract with Alliance or to make changes to your contract with Alliance.

We encourage you to contract with each LME/MCO to maximize statewide resources and service access for children and adolescents. For more information about becoming an in-network provider, please use the following links:

Alliance Health (Cumberland, Durham, Johnston, Mecklenburg, Orange and Wake counties)

Eastpointe (Duplin, Edgecombe, Greene, Lenoir, Robeson, Sampson, Scotland, Warren, Wayne and Wilson counties)

Partners Health Management (Burke, Cabarrus, Catawba, Cleveland, Davie, Forsyth, Gaston, Iredell, Lincoln, Rutherford, Stanly, Surry, Union, and Yadkin counties)

Sandhills Center (Anson, Davidson, Guilford, Harnett, Hoke, Lee, Montgomery, Moore, Randolph, Richmond and Rockingham counties)

Trillium Health Resources (Beaufort, Bertie, Bladen, Brunswick, Camden, Carteret, Chowan, Columbus, Craven, Currituck, Dare, Gates, Halifax, Hertford, Hyde, Jones, Martin, Nash, New Hanover, Northampton, Onslow, Pamlico, Pasquotank, Pender, Perquimans, Pitt, Tyrrell, and Washington counties)

Vaya Health (Alamance, Alexander, Alleghany, Ashe, Avery, Buncombe, Caldwell, Caswell, Chatham, Cherokee, Clay, Franklin, Graham, Granville, Haywood, Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Person, Polk, Rowan, Stokes, Swain, Transylvania, Vance, Watauga, Wilkes, and Yancey counties)

What if a provider does not want to join an LME/MCO network at this time?

For providers who do not want to join an LME/MCO network, all LME/MCOs are offering out-of-network agreements for community-based and non-hospital services. While the NC DHHS directs reimbursement for these services to be 90% of the Medicaid rate, the LME/MCOs have agreed to pay at least 100% of the Medicaid rate for these services to strengthen the statewide network and service capacity.

If you have questions, please contact our Provider Help Desk at [email protected].


Innovations Specialized Consultative Services

Licensed independent professionals (LIPs) to provide Innovations specialized Cconsultative services that supply expertise, training and technical assistance in a specialty area to assist family members, support staff and other natural supports in assisting Innovations beneficiaries with developmental disabilities who have long-term intervention needs.

  • Interested LIPs should have at least one year of documented experience in writing behavior intervention plans for the I/DD population and meet the qualifications in the service definition, Clinical Coverage Policy 8P.
  • Interested LIPs should complete the Provider Application Request and submit it with a current CV.

TBI Waiver Service Needs

Specialized Consultative Services


Who Can Provide Per the Waiver:

  • Provider agency: National accreditation required.
  • Individual independent practitioners: Licensure specific to discipline, if applicable.

Waiver Definition:

Specialized consultation services provide expertise, training, and technical assistance in a specialty area.

Specialty Areas: Neuro/psychology, behavior intervention, speech therapy, therapeutic recreation, augmentative communication, assistive technology equipment, occupational therapy, physical therapy, nutrition, and other licensed professionals who possess experience with individuals with traumatic brain injury.

Service Goal: To assist family members, support staff, and other natural supports in assisting individuals with traumatic brain injury.

Minimum Requirements:

  • A minimum of 500 hours supporting individuals with TBI.
  • Staff must hold appropriate NC license for physical therapy, occupational therapy, speech therapy, psychology, behavioral analysis (licensure subject to psychology board implementation date) and nutrition; state certification for recreational therapy; board-certified behavior analyst-MA; master’s degree and expertise in augmentative communication; state certification in assistive technology.
  • Qualified in the customized need of the beneficiaries as described in the individual support plan.
  • Must be enrolled in NCTracks.

Providers are expected to meet the requirements of the CMS approved TBI Waiver and Alliance credentialing, enrollment, and contracting requirements, including being enrolled in NCTracks.

Interested providers, please submit the Alliance Provider Application Request to [email protected] along with an agency summary or CV that demonstrates the minimum of 500 hours supporting individuals with TBI, a copy of the appropriate license (as applicable), and a copy of national accreditation (as applicable).

Cognitive Rehabilitation

Who can provide per the waiver:

  • Individual practitioner: Licensure specific to discipline, NC G.S.122C.
  • Provider agency: NC G.S.122C, as appropriate.

Staff must hold appropriate NC license.

Cognitive rehabilitation (CR) must be provided by independent physicians, neuropsychologists, or psychologists.

Degree required in behavioral science field or other appropriate field with appropriate licensure and/or certification for that particular field (i.e., psychology, social work, special education, speech-language pathology, occupational therapy or counseling).

Can be LPC, LCSW, special education teachers, occupational therapists and speech-language pathologists, licensed to practice in the State of North Carolina.

Waiver definition:

Cognitive rehabilitation is an one-on-one therapy, utilized for the development of cognitive (thinking) skills to improve functional abilities including but not limited to: attention, memory, problem solving, and to help identify impaired thinking.

Minimum requirements:

  • A minimum of 500 hours supporting individuals with TBI.
  • PhD and master’s degree: must have 40 hours of training in brain injury and one year of experience working with persons with brain injury; Bachelor’s degree: must have 40 hours of training in brain injury and three years of experience working in brain injury.
  • Qualified in the customized need of the beneficiaries as described in the individual support plan.
  • Must be enrolled in NCTracks.

Providers are expected to meet the requirements of the CMS approved TBI Waiver and Alliance credentialing, enrollment, and contracting requirements, including being enrolled in NCTracks.

Interested providers, please submit the Alliance Provider Application Request to [email protected] along with an agency summary or CV that demonstrates the minimum of 500 hours supporting individuals with TBI, a copy of the appropriate license (as applicable), and a copy of national accreditation (as applicable).

Allied Health: Physical Therapy, Occupational Therapy, and Speech and Language Therapy

Who Can Provide Per the Waiver:

  • PT/OT/SLP provider agencies.
  • Individual licensed therapists.

Staff must hold appropriate NC license for occupational therapy, physical therapy, or speech and language therapy.

Service Definition:

Occupational Therapy: The goal of occupational therapy is to assist individuals with TBI achieve greater independence by regaining physical, perceptual, and cognitive skills through exercises and other related activities.

Speech and Language Therapy: The goal of speech and language therapy is to assist individuals with TBI who have difficulties with communication, eating, drinking or swallowing.

Physical Therapy: Physical therapy is a treatment approach to assist individuals with TBI that addresses the promotion of sensor motor function through enhancement of musculoskeletal status, neurobehavioral organization, perceptual and motor development, cardiopulmonary status, and effective environmental adaptation

Waiver Minimum Allied Health Requirements:

  • A minimum of 500 hours supporting individuals with TBI.
  • Staff must hold appropriate NC license for physical therapy, occupational therapy, speech therapy.
  • Qualified in the customized need of the beneficiaries as described in the individual support plan.
  • Must be enrolled in NCTracks.

Providers are expected to meet the requirements of the CMS approved TBI Waiver and Alliance credentialing, enrollment, and contracting requirements, including being enrolled in NCTracks.

Interested providers, please submit the Alliance Provider Application Request to [email protected] along with an agency summary or CV that demonstrates the minimum of 500 hours supporting individuals with TBI, a copy of the appropriate license (as applicable), and a copy of national accreditation (as applicable).

Supported Living:

Who Can Provide Per the Waiver:

Provider Qualifications:
Provider Agencies in PIHP network. State Nursing Board regulations must be followed for tasks that present health and safety risks to the person/s as directed by the PIHP medical director or assistant medical director. Upon enrollment as a provider, the Agency With Choice (AWC) must have achieved national accreditation with at least one of the designated accrediting agencies. Employers of record (EOR) have an arrangement with an enrolled crisis services provider to respond to person/s crisis situations.
Staff or live-in caregiver are at least 18 years of age and meet the following requirements:

  • If providing transportation, have valid NC driver’s license or other valid driver’s license, a safe driving record an acceptable level of automobile liability insurance
  • Criminal background check presents no health and safety risk to person/s
  • Not listed in NC Health Care Abuse Registry
  • Qualified in CPR and First Aid
  • Qualified in the customized needs and TBI needs of the person/s as described in the ISP
  • High school diploma or equivalency (GED)
  • Paraprofessionals providing this service must also be supervised by a qualified professional. Supervision must be provided according to supervision requirements specified in 10A NCAC 27G.0204 (b) (c) and (f) and according to licensure or certification requirements of the appropriate discipline.

Waiver Definition:

Supported Living provides a flexible partnership that enables a TBI Waiver beneficiary to live in their own home with support from an agency that provides individualized assistance.

The service includes direct assistance as needed with activities of daily living, household chores essential to the health and safety of the beneficiary, budget management, attending appointments, and interpersonal and social skills building to enable the beneficiary to live in a home in the community. Training activities, supervision, and assistance may be provided to allow the beneficiary to participate in home life or community activities. Other activities include assistance with monitoring health status and physical condition, and assistance with transferring, ambulation and use of special mobility devices.

Service Goal: Supported Living provides a flexible partnership that enables a TBI Waiver beneficiary to live in their own home with support from an agency that provides individualized assistance in a home that is under the control and responsibility of the beneficiary as specified in the person-centered plan.

Minimum Requirements:

  • Provider must be enrolled in NCTracks.
  • Provider must be  qualified in the customized need of the beneficiaries as described in the individual support plan.
  • The Agency With Choice (AWC) must have achieved national accreditation with at least one of the designated accrediting agencies.
  • Employers of record (EOR) have an arrangement with an enrolled crisis services provider to respond to person/s crisis situations.

Interested providers should submit the Alliance Provider Application Request to [email protected] and copy of national accreditation (as applicable). To learn more about TBI Waiver see Alliance’s TBI Waiver Web page and or send questions to TBI waiver communication at [email protected].

Providers are expected to meet the requirements of the CMS approved TBI Waiver and Alliance enrollment, and contracting requirements to include being enrolled in NCTracks.

Interested providers should complete the provider application request and submit to [email protected] for consideration.


Research-Based Behavioral Health Treatment(RB-BHT) for Autism Spectrum Disorder (ASD)

Research-based behavioral health treatments (RB-BHT) services are researched-based behavioral intervention services that prevent or minimize the disabilities and behavioral challenges associated with autism spectrum disorder (ASD) and promote, to the extent practicable, the adaptive functioning of a beneficiary. RB-BHT demonstrate clinical efficacy in treating ASD: prevent or minimizes the adverse effects of ASD; and promote, to the maximum extent possible, the functioning of a beneficiary.

Providers are expected to meet the requirements of the NC Medicaid Clinical Coverage Policy 8F and Alliance credentialing, enrollment, and contracting requirements to include being enrolled in NCTracks.

Interested providers should complete the Provider Application request and submit to [email protected] for consideration.


New Medications for Opioid Use Disorder (MOUD: Buprenorphine) Service Definition Modifiers for Medicaid-Funded Outpatient Services

Alliance has developed a new service definition modifier to support the implementation of evidence-based medication-assisted treatment for individuals diagnosed with Opioid Use Disorder. This service must be provided by psychiatrists who have been approved to prescribe buprenorphine (including monotherapy or FDA-approved buprenorphine combination therapies) and who adhere to evidence-based treatment requirements as described in the scope of work.

The new service codes are modifications of existing psychiatry evaluation and management (E&M) codes and will be reimbursed at a higher rate than existing E&M codes to cover the additional provider expenses associated with fidelity to medication-assisted treatment requirements. Eligible providers include licensed independent practitioner (LIP) psychiatrists and provider agencies. Providers who are interested in adding this service to their contracts must meet the following requirements:

  1. Psychiatrists with an office in the Alliance Health catchment area.
  2. Provider must submit documentation demonstrating that psychiatrist has been approved by the Drug Enforcement Administration (DEA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) to prescribe buprenorphine.
  3. Provider must submit policies and procedures specific to opioid treatment and a program overview that describes how the program will adhere to MOUD requirements as described in the scope of work.

Please submit a Provider Application Request with attachments noted in numbers 2 and 3 above.


Fluency in Spanish or Other Languages

Fully-licensed licensed independent professionals (LIPs) in a solo practice that are fluent in Spanish or other languages, with an office located within the Alliance catchment area.


Psychiatrists

Psychiatrists with an office located within the Alliance catchment area.

Experience with the MH/SA/IDD population is required.

This page was last reviewed for accuracy on 10/12/2020