Medicaid Behavioral Health Services: Case Management

2022

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 32; No - 13; NR - 6	Yes - 1	Yes - 13
Alabama	Yes	Yes - not specified	No
Alaska	Yes	No	No
Arizona	Yes	NR	No
Arkansas	NR	NR	NR
California	Yes	No	No
Colorado	No
Connecticut	No
Delaware	NR	NR	NR
District of Columbia	Yes	No	Transition planning services require prior authorization (no limits for clinicial care coordination services)
Florida	Yes	No	Mental health targeted case management is limited to of 344 15-minute units per month; intensive team targeted case management is limited to 48 15-minute units per day
Georgia	NR	NR	NR
Hawaii	Yes	No	No
Idaho	Yes	No	No
Illinois	Yes	No	Only covered for mental health conditions. Annual limit of 240 hours per recipient across all case management services; annual limit of 40 hours per recipient for transition, linkage, and aftercare case management services
Indiana	Yes	No	Varies by level of need; Medicaid Rehabilitation Option package of services is required
Iowa	Yes	No	No
Kansas	Yes	No	No
Kentucky	Yes	No	NR
Louisiana	No
Maine	Yes	No	No
Maryland	Yes	No	NR
Massachusetts	No
Michigan	Yes	No	No
Minnesota	NR	NR	NR
Mississippi	Yes	No	For community mental health centers only, limit of 96 per day, 15 minute units, 400 per state fiscal year
Missouri	Yes	No	No
Montana	Yes	No	No
Nebraska	Yes	No	No
Nevada	Yes	No	Prior authorization typically required after 30 hours per month of targeted case management
New Hampshire	NR	NR	NR
New Jersey	Yes	No	No
New Mexico	No
New York	No
North Carolina	Yes	No	Prior authorization is required
North Dakota	No
Ohio	Yes	No	Yes - not specified
Oklahoma	No
Oregon	Yes	No	Limit of 100 units, with a 15 minute unit max
Pennsylvania	No
Rhode Island	Yes	No	No
South Carolina	Yes	No	No
South Dakota	No
Tennessee	No
Texas	No
Utah	NR	NR	NR
Vermont	Yes	No	Yes - not specified
Virginia	Yes	No	Registration is required
Washington	No
West Virginia	Yes	No	Based on medical necessity
Wisconsin	Yes	No	Limits on units per day
Wyoming	Yes	No	No

2018

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 29 No - 17 NR - 5	Yes - 2	Yes - 11
Alabama	No
Alaska	Yes	No	No
Arizona	Yes	No	No
Arkansas	Yes	NR	NR
California	Yes	No	No
Colorado	Yes	No	No
Connecticut	No
Delaware	No
District of Columbia	No
Florida	No
Georgia	Yes	No	No
Hawaii	Yes	No	No
Idaho	Yes	No	No
Illinois	NR	NR	NR
Indiana	Yes	No	Medicaid Rehab Option package of services required
Iowa	NR	NR	NR
Kansas	Yes	No	Must meet state criteria for serious and persistent mental illness
Kentucky	No
Louisiana	No
Maine	No
Maryland	No
Massachusetts	No
Michigan	Yes	No	No
Minnesota	Yes	No	NR
Mississippi	Yes	No	TCM: Limited to 2 Daily, Maximum 260 Yearly; CSS: Limited to 6 Daily, Maximum 400 Yearly.
Missouri	Yes	No	No
Montana	Yes	No	No
Nebraska	No
Nevada	Yes	Yes - Not Specified	There are 9 separate target groups that may access TCM services.
New Hampshire	NR	NR	NR
New Jersey	Yes	No	Targeted case management only
New Mexico	No
New York	NR	NR	NR
North Carolina	Yes	No	One unit per week of at least 15 minutes
North Dakota	No
Ohio	Yes	No	No
Oklahoma	Yes	$4 per visit	Individuals 18 and older who are chronically/severely mentally ill who are at imminent risk of out-of-home placement due to psychiatric or substance abuse reasons. Standard case management limited to 16 units per member per year. Additional units may be authorized for members who meet established medical necessity criteria.
Oregon	Yes	No	No
Pennsylvania	No
Rhode Island	Yes	No	No
South Carolina	NR	NR	NR
South Dakota	No
Tennessee	No
Texas	No
Utah	Yes	No	No
Vermont	Yes	No	Must be medically necessary
Virginia	Yes	No	No
Washington	Yes	No	Some require prior authorization
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

Topics

Policy Research

Polling

Health News

Data & Features

For Media

About

Medicaid Behavioral Health Services: Case Management

Data are loading

Medicaid Behavioral Health Services: Case Management

2022

2018

Topics

Categories