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.

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Medicaid B: Child and Adolescent Day Treatment and Co-Occurring Day Treatment

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About

Coverage

Medicaid Direct (Medicaid B)

Diagnosis Group(s)

Developmental Disability, Mental Health, Substance Use

Age Group(s)

18-20, Child

Reference Documents

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)

Service Definition Authorization Parameters

60 day authorization periods up to 129 units per month

ASAM Level of Care

2.1

Request Prior Approval from Alliance Health

Service Codes & Descriptions

H2012 HA U5 Co-occurring DayTx for up to 8 youth
H2012 HA- Day Tx Behavioral Health Child

Full Service Definition

<a target="_blank" href="https://medicaid.ncdhhs.gov/8a-enhanced-mental-health-and-substance-abuse-services/download?attachment">Download PDF</a>

Alliance Statement of Work

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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.

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Medicaid B: Child and Adolescent Day Treatment and Co-Occurring Day Treatment

Full Service Definition

Alliance Statement of Work

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