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Medicaid - Ambulatory Detoxification

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About

Coverage Information Icon

Medicaid B

Diagnosis Group(s) Information Icon

Substance Use, Assessment Only

Age Group(s) Information Icon

Adult, 18-20

Reference Documents

No Reference Documents have been attached to this service.

Authorization

Submission Requirements Information Icon

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

 

Service Definition Authorization Parameters Information Icon

https://medicaid.ncdhhs.gov/providers/program-specific-clinical-coverage-policies

 

  • Initial: 7 days
  • Concurrent: 3 days
  • Maximum 10 days per episode

ASAM Level of Care Information Icon

1-WM

Service Codes & Descriptions

  • H0014 - Ambulatory Detoxification

No Reference Documents have been attached to this service.