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Medicaid B - Community Support Team (CST)
About
Coverage
Medicaid B
Diagnosis Group(s)
Developmental Disability, Mental Health, Substance Use
Age Group(s)
18-20, Adult, Child
Authorization
Submission Requirements
Initial:
- Service Authorization Request (SAR)
- Person Centered Plan (PCP) with Service Order
- Comprehensive Clinical Assessment (CCA)
Concurrent:
- Service Authorization Request (SAR)
- Updated Person Centered Plan (PCP)
- Functional Assessment
- Comprehensive Clinical Assessment (CCA) or CCA addendum if length of stay exceeds 6 months
Service Definition Authorization Parameters
- No prior authorization required for first 36 units of service for 3 calendar days
- Pass through available once per treatment episode per state fiscal year
Initial:
- Up to 128 units/60 days
- Up to 420 units/60 days if searching for stable housing
Concurrent:
- Up to 192 units/90 days
- Up to 630 units/90 days if searching for stable housing
COVID Prior Approval Flexibility:
- Waive Prior Approval for Concurrent Requests
Locus Level
| 1 | 2 | 3 | 4 | 5 | 6 |
|---|---|---|---|---|---|
|
|
ASAM Level of Care
2.1
Service Codes & Descriptions
- H2015HT HF - CST LCAS, other SA
- H2015HT HF CR CST LCAS, other SA
- H2015HT HF GT CR CST LCAS, other SA
- H2015 HT HM - CST Paraprofessional
- H2015 HT HM CR - CST Paraprofessional
- H2015 HT HM GT CR- CST Paraprofessional
- H2015 HT HN - CST QP/AP
- H2015 HT HN CR - CST QP/AP
- H2015 HT HN GT CR- CST QP/AP
- H2015 HT HO - CST Team Lead
- H2015 HT HO CR - CST Team Lead
- H2015 HT HO GT CR- CST Team Lead
- H2015 HT U1 - CST NC Peer Support Specialist
- H2015 HT U1 CR - CST NC Peer Support Specialist
- H2015 HT U1 GT CR- CST NC Peer Support Specialist
Full Service Definition
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