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Medicaid B - Case Support

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About

Coverage

Medicaid B

Diagnosis Group(s)

All

Age Group(s)

18-20, Adult, All, Child

Reference Documents

Authorization

Submission Requirements

Initial:

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

Concurrent:

  • Service Authorization Request (SAR)
  • Person Centered Plan (PCP) with step-down plan to appropriate service

Service Definition Authorization Parameters

  • 120 units/month unmanaged
  • Beyond unmanaged benefit: up to 10 units/30 days with step-down plan

Locus Level

1 2 3 4 5 6
Green check Green check Green check

Service Codes & Descriptions

  • T1016 CR Case Support/Case management, each 15 minutes

Alliance Statement of Work