NC Medicaid will delay Tailored Plan launch beyond October 2023. A new launch date has not been announced. Due to the budget delay, Medicaid Expansion will not launch on October 1, 2023 . Final authority must be granted by the General Assembly.

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Medicaid - Ambulatory Detoxification

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About

Coverage

Medicaid B

Diagnosis Group(s)

Substance Use, Assessment Only

Age Group(s)

Adult, 18-20

Reference Documents

No Reference Documents have been attached to this service.

Authorization

Submission Requirements

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

Service Definition Authorization Parameters

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

1-WM

Request Prior Approval from Alliance Health

Service Codes & Descriptions

H0014 - Ambulatory Detoxification

No Reference Documents have been attached to this service.

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

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