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Alliance members impacted by the launch of the Child and Families Specialty Plan (CFSP) are invited to get more information by contacting Healthy Blue Care Together (HBCT) at 844-594-5072 or [email protected], or by contacting the NC Medicaid Ombudsman at 1-877-201-3750.

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Home / Services / Non-Medicaid: Child and Adolescent Day Treatment

Non-Medicaid: Child and Adolescent Day Treatment

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About

Coverage Information Icon

Non-Medicaid (State)

Diagnosis Group(s) Information Icon

Mental Health, Substance Use, Developmental Disability

Age Group(s) Information Icon

Child

Reference Documents

Authorization

Submission Requirements Information Icon

  • Service Authorization Request (SAR)
  • Person Centered Plan (PCP)/Person Centered Plan (PCP) Update
  • Comprehensive Clinical Assessment (CCA)

Authorization Duration and Limits Information Icon

Initial:

  • 504 hours over 210 days

Concurrent:

  • None

Expected Breakdown:

  • Months 1-2 = 30 hours/week
  • Months 3-4 = 20 hours/week
  • Months 5-6 = 10 hours/week
  • Month 7 = 6 hours/week

Request Prior Approval from Alliance Health

Service Codes & Descriptions

  • H2012 HA- Day Tx Behavioral Health Child
  • YA404 Child and Adolescents Day Treatment Provided During Disaster or Emergency – State

Full Service Definition

<a target="_blank" href="https://www.ncdhhs.gov/state-funded-enhanced-mental-health-and-substance-use-services-2024-10-01-24/download?attachment">Download PDF</a>
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