BHDD Medicaid Services Provider Manual Effective March 8, 2025
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Medicaid Manual
Introduction |
Issued/ Revised |
|
| 001 | Purpose | 10/01/2022 |
| 002 | Definitions | 01/01/2025 |
100 |
Section 1 - General Requirements |
Issued/ Revised |
| 105 | Severe and Disabling Mental Illness | 05/12/2023 |
| 110 | Substance Use Disorder | 10/01/2022 |
| 115 | Assessments | 10/01/2022 |
| 120 | Individualized Treatment Plans for Behavioral Health Treatment | 10/01/2022 |
| 130 | Progress Notes | 10/01/2022 |
| 135 | Continuing Care Plan | 10/01/2022 |
200 |
Section 2 - Utilization Management |
Issued/ Revised |
| 205 | Requesting a Prior Authorization – Non-Acute Services | 10/01/2022 |
| 206 | Requesting Auto Authorization – Acute Services | 10/01/2022 |
| 206QA | Auto-Authorization Quality Assurance | 10/01/2022 |
| 210 | Requesting a Continued Stay Review – Non-Acute Services | 10/01/2022 |
| 215 | Utilization Review Determinations and Notifications | 05/12/2023 |
| 220 | Reconsideration Review Process | 10/01/2022 |
| 230 | Integrated Service Delivery | 3/08/2025 |
300 |
Section 3 - Administrative Reviews |
Issued/ Revised |
| 305 | Retrospective and Quality Reviews | 01/01/2025 |
| 310 | Administrative Review, Fair Hearing, & Sanctions | 05/12/2023 |
500 |
Section 5 – Medicaid Substance Use Disorder (SUD) Services |
Issued/ Revised |
| 505 | Specimen Collection for SUD Drug Testing | 10/01/2022 |
| 510 | SUD Targeted Case Management | 10/01/2022 |
| 514 | Screening, Brief Intervention, and Referral to Treatment (SBIRT) | 10/01/2022 |
| 515 | SUD Certified Behavioral Health Peer Support Services (CBHPSS) - Adult | 05/12/2023 |
| 520 | SUD Outpatient (OP) Therapy (ASAM 1.0) | 10/01/2022 |
| 525 | SUD Intensive Outpatient (IOP) Therapy (ASAM 2.1) | 03/08/2025 |
| 530 | SUD Partial Hospitalization (ASAM 2.5) | 01/01/2025 |
| 535 | SUD Clinically Managed Low-Intensity Residential (ASAM 3.1) | 03/08/2022 |
| 536 | SUD Withdrawal Management (ASAM 3.2) (New) | 10/01/2022 |
| 537 | SUD Clinically Managed Population‐specific High‐Intensity Residential (ASAM 3.3) Adult (New) | 10/01/2022 |
| 540 | SUD Clinically Managed High-Intensity Residential (ASAM 3.5) | 10/01/2022 |
| 545 | SUD Medically Monitored Intensive Inpatient (ASAM 3.7) | 10/01/2022 |
| 550 | Medication Assisted Treatment (MAT) | 10/01/2022 |
600 |
Section 6 – Medicaid HEART Waiver (NEW) |
Issued/ Revised |
| 600 | HEART Waiver- Purpose | 01/01/2025 |
| 602 | HEART Waiver – Tenancy Support Services – Progress Notes | 01/01/2025 |
| 603 | HEART Waiver – Tenancy Support Service – Eligibility and Enrollment | 01/01/2025 |
| 604 | HEART Waiver – Tenancy Support Service – Housing Plan | 01/01/2025 |
| 605 | HEART Waiver – Tenancy Support Service – TSS | 01/01/2025 |
| 606 | HEART Waiver – Tenancy Support Service – Application Fee and Security Deposit Assistance | 01/01/2025 |
If you are looking for more information regarding HEART Waiver, you can find it on our HEART Waiver Services page.
Medicaid Manual Resources
HEART Waiver Referral to Tenancy Support Services Form
- To complete a phone referral to Tenancy Support Services, please call: (406) 443-0320 or 1(800) 219-7035
