Skip to main content

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.

Alliance Health
Provider Support: 855-759-9700
Provider Portal Log In AllianceHealthPlan.org

Provider Central Search

Use the search function below to search Provider Central

Home / Services / Medicaid B: Psychiatric Residential Treatment Facility (PRTF)

Medicaid B: Psychiatric Residential Treatment Facility (PRTF)

Left Arrow Icon Back to Services

About

Coverage Information Icon

Medicaid B

Diagnosis Group(s) Information Icon

Mental Health, Substance Use, Developmental Disability

Age Group(s) Information Icon

All, Child, 18-20

Reference Documents

Authorization

Submission Requirements Information Icon

Psychiatric Residential Treatment Facility (PRTF) 30 Day Assessment 0919
Psychiatric Residential Treatment Facility (PRTF) RC911
New Hope Treatment Center (LEAP Program) RC911
Mandatory referral to Care Management
Initial: In Network Providers are eligible for Notification Authorization of 60 days if member is 14+ years old.  Out of Network providers are not eligible for Notification Authorization and are required to submit the following:

  • Service Authorization Request (SAR)
  • Certificate of Need (CON)
  • Person Centered Plan (PCP) with Service Order
  • Comprehensive Clinical Assessment (CCA) completed within 30 calendar days from the requested initial authorization start date

Concurrent

  • Service Authorization Request (SAR)
  • Updated Person Centered Plan (PCP)
  • For length of stay beyond 180 days: updated Psychiatric or Psychological Evaluation

Service Definition Authorization Parameters Information Icon

Psychiatric Residential Treatment Facility (PRTF) 30 Day Assessment 0919
Initial: up to 30 days

Psychiatric Residential Treatment Facility (PRTF) RC911
Initial and Concurrent: up to 30 days

Request Prior Approval from Alliance Health

Service Codes & Descriptions

  • RC911 - PRTF
  • 0919- Specialized PRTF Assessment Program

Full Service Definition

<a target="_blank" href="https://medicaid.ncdhhs.gov/8d-1-psychiatric-residential-treatment-facilities-children-under-age-21/download?attachment">Download PDF</a>
Download PDF

Alliance Statement of Work

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.