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NC Medicaid Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans will launch July 1, 2024. Choice period ends on May 15, 2024. Please call to select your PCP. Find PCPs available in our health plan.

Effective February 1, 2024, citizens of Harnett County are being served by Alliance Health. Access more information for health plan participants or for providers.

Alliance Health
Provider Support: 855-759-9700
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Home / Services / Medicaid 1915i: Respite

Medicaid 1915i: Respite

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About

Coverage Information Icon

Medicaid Direct (Medicaid B)

Diagnosis Group(s) Information Icon

Mental Health, Substance Use, Developmental Disability

Age Group(s) Information Icon

All, Adults 18+, Child, 18-20

Reference Documents

Authorization

Submission Requirements Information Icon

Care Managers (not the provider of the service) submit ALL requests for 1915i services.

Member must be determined eligible for 1915i services.

  • Service Authorization Request (SAR)
  • Service Plan, Care Plan, or Person Centered Plan (PCP) with Service Order

Service Definition Authorization Parameters Information Icon

  • 1 unit = 15 minutes of Respite
  • No more than 300 hours (1200 units) can be provided in a plan year

Request Prior Approval from Alliance Health

Service Codes & Descriptions

  • H0045 U4 - Respite Individual Child
  • H0045 HB U4 Respite Individual Adult
  • H0045 HQ HB U4- Respite Group Adult
  • H0045 HQ U4 Respite Group Child

Service Description

Respite provides relief to caregivers. This service is available to families of children with Behavioral Health needs and all ages for Intellectual and Developmental Disabilities needs.

When submitting requests for 1915i Respite Services in ACS, please choose Definition = 1915i Services
Following are the correct codes to submit when requesting 1915i Respite Services:

H0045 U4 = Respite Individual Child
H0045 HQ U4 = Respite Group Child
H0045 HB U4 = Respite Individual Adult
H0045 HQ HB U4 = Respite Group Adult

Full Service Definition

<a target="_blank" href="https://medicaid.ncdhhs.gov/8h-4-1915i-respite/download?attachment">Download PDF</a>
Download PDF

Alliance Provider Support is available to answer provider questions about authorization, billing, claims, enrollment, ACS, or other issues.

Call 855-759-9700 Monday-Saturday from 7:00am-6:00pm.