Medicaid Behavioral Health Services: Assertive Community Treatment

2022

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 39; No - 6; NR - 6	Yes - 2	Yes - 14
Alabama	Yes	Yes - not specified	No
Alaska	Yes	No	NR
Arizona	Yes	NR	No
Arkansas	NR	NR	NR
California	No
Colorado	Yes	No	No
Connecticut	Yes	No	No
Delaware	NR	NR	NR
District of Columbia	Yes	No	Prior authorization is required; initial and subsequent authorization limited to 180 calendar days and 500 units
Florida	Yes	No	No
Georgia	NR	NR	NR
Hawaii	Yes	No	No
Idaho	No
Illinois	Yes	No	No
Indiana	No
Iowa	Yes	No	No
Kansas	Yes	No	No
Kentucky	Yes	No	NR
Louisiana	Yes	No	NR
Maine	Yes	No	Minimum of 3 days per week face-to-face contact is required
Maryland	Yes	No	NR
Massachusetts	Yes	No	No
Michigan	Yes	No	No
Minnesota	NR	NR	NR
Mississippi	Yes	No	For community mental health centers only, limit of 40 per day, 15 minute units, 1600 per state fiscal year; prior authorization is requied
Missouri	Yes	No	No
Montana	Yes	No	Requires prior authorization and continued stay reviews
Nebraska	Yes	No	No
Nevada	Yes	No	Prior authorization is required for the individual service (not bundled rate/package)
New Hampshire	NR	NR	NR
New Jersey	Yes	No	No
New Mexico	Yes	No	No
New York	Yes	No	No
North Carolina	Yes	No	Prior authorization is required
North Dakota	No
Ohio	Yes	No	Prior authorization is required
Oklahoma	Yes	$3	No
Oregon	Yes	No	Limit of 100 units, with a 15 minute unit max
Pennsylvania	No
Rhode Island	Yes	No	Diagnostic and functional assessment criteria must be met
South Carolina	No
South Dakota	Yes	No	Must have SMI diagnosis
Tennessee	Yes	No	No
Texas	Yes	No	Only covered as part of Mental Health Rehabilitation services array; must have a diagnosis of serious mental illness and poor functioning in one or more life domains to qualify
Utah	NR	NR	NR
Vermont	Yes	No	Limited to persons with functional impairments and/or cognitive disabilities
Virginia	Yes	No	Service authorization is required
Washington	Yes	No	No
West Virginia	Yes	No	NR
Wisconsin	Yes	No	Functional eligibility requirements
Wyoming	Yes	No	No

2018

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 33 No - 13 NR - 5	Yes - 2	Yes - 14
Alabama	Yes	No	365 days per year
Alaska	No
Arizona	Yes	No	No
Arkansas	No		Yes - Not Specified
California	No
Colorado	Yes	No	No
Connecticut	No
Delaware	No
District of Columbia	Yes	No	No
Florida	No
Georgia	Yes	No	No
Hawaii	Yes	No	No
Idaho	No
Illinois	NR	NR	NR
Indiana	No
Iowa	NR	NR	NR
Kansas	No
Kentucky	Yes	Co Pay $3	No
Louisiana	Yes	No	NR
Maine	Yes	No	Minimum of 3 days per week face to face contact required
Maryland	Yes	No	Services are pre-authorized
Massachusetts	Yes	No	No
Michigan	Yes	No	No
Minnesota	Yes	No	NR
Mississippi	Yes	No	Requires prior authorization and Limited to 40 Daily, Maximum of 1600 yearly.
Missouri	Yes	No	No
Montana	Yes	No	Prior Authorization/Continued Stay Reviews
Nebraska	Yes	No	No
Nevada	Yes	No	PA requirements for the individual services. This is not a bundled rate/package.
New Hampshire	NR	NR	NR
New Jersey	Yes	No	No
New Mexico	Yes	No	No
New York	NR	NR	NR
North Carolina	Yes	No	Prior approval required on the first day of service
North Dakota	No
Ohio	Yes	No	Assertive Community Treatment (adults age 18 & over) requires prior authorization of medical necessity prior to initiation of treatment.
Oklahoma	Yes	$4 per visit	PACT services are billable in 15 minute units. A maximum of 105 hours per member per year in the aggregate is allowed. All PACT compensable SoonerCare services are required to be face-to-face.
Oregon	Yes	No	No
Pennsylvania	No
Rhode Island	Yes	No	No
South Carolina	NR	NR	NR
South Dakota	No
Tennessee	Yes	No	No
Texas	Yes	No	Only covered as part of the mental health rehabilitation service array. Adults must have an SMI diagnosis and have poor functioning in one or more life domains to qualify.
Utah	Yes	No	No
Vermont	Yes	No	Limited to persons with functional impairments and/or cognitive disabilities.
Virginia	Yes	No	No
Washington	No
West Virginia	Yes	No	PA Required
Wisconsin	Yes	No	No
Wyoming	Yes	No	Prior authorization is required after the first 20 visits to confirm ongoing medical necessity

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Medicaid Behavioral Health Services: Assertive Community Treatment

2022

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