Medicaid Behavioral Health Services: Day Treatment

2022

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 33; No - 12; NR - 6	Yes - 2	Yes - 9
Alabama	Yes	Yes - not specified	No
Alaska	Yes	No	No
Arizona	Yes	NR	No
Arkansas	NR	NR	NR
California	Yes	No	No
Colorado	Yes	No	No
Connecticut	Yes	No	No
Delaware	NR	NR	NR
District of Columbia	Yes	No	Authorization is required for more than 90 days of service within a 12 month period
Florida	No
Georgia	NR	NR	NR
Hawaii	No
Idaho	No
Illinois	Yes	No	No
Indiana	Yes	No	Varies by level of need; Medicaid Rehabilitation Option package of services is required
Iowa	Yes	No	No
Kansas	No
Kentucky	Yes	No	NR
Louisiana	No
Maine	Yes	No	No
Maryland	Yes	No	NR
Massachusetts	Yes	No	No
Michigan	Yes	No	No
Minnesota	NR	NR	NR
Mississippi	No
Missouri	Yes	No	No
Montana	Yes	No	No
Nebraska	Yes	No	No
Nevada	Yes	No	Prior authorization is required; limits vary by level of care
New Hampshire	NR	NR	NR
New Jersey	Yes	No	No
New Mexico	Yes	No	No
New York	Yes	No	No
North Carolina	No
North Dakota	No
Ohio	Yes	No	Prior authorization may be required after utilization thresholds
Oklahoma	No
Oregon	Yes	No	No
Pennsylvania	No
Rhode Island	Yes	No	No
South Carolina	No
South Dakota	Yes	Yes - not specified	Must have SMI diagnosis
Tennessee	Yes	No	No
Texas	Yes	No	Only covered as part of Mental Health Rehabilitation services array; limit of 3 units per day
Utah	NR	NR	NR
Vermont	Yes	No	No
Virginia	No
Washington	Yes	No	Services must be available 5 hours a day, 5 days a week
West Virginia	Yes	No	Based on medical necessity
Wisconsin	Yes	No	Subject to prior authorization
Wyoming	Yes	No	No

2018

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 34 No - 12 NR - 5	Yes - 3	Yes - 16
Alabama	Yes	No	4 hours per day, 1040 hours per year
Alaska	Yes	No	No
Arizona	Yes	No	No
Arkansas	Yes	NR	NR
California	Yes	No	No
Colorado	Yes	No	No
Connecticut	Yes	No	Authorization required
Delaware	Yes	No	No
District of Columbia	Yes	No	PA required for utilization above certain benchmarks
Florida	No
Georgia	No
Hawaii	No
Idaho	No
Illinois	NR	NR	NR
Indiana	Yes	No	Medicaid Rehab Option package of services required
Iowa	NR	NR	NR
Kansas	No
Kentucky	Yes	$3 copay	No
Louisiana	No
Maine	Yes	No	No
Maryland	No
Massachusetts	Yes	No	No
Michigan	Yes	No	No
Minnesota	Yes	No	A recipient may receive no more than 15 hours of day treatment per week.
Mississippi	No
Missouri	Yes	No	No
Montana	Yes	No	3 hour per day limit with exceptions
Nebraska	Yes	No	Yes - Not Specified
Nevada	Yes	No	Prior Authorization (PA) required. Level of Care (LOC) 4, maximum 5 hours per day. LOC 5 & 6, max 6 hours per day.
New Hampshire	NR	NR	NR
New Jersey	Yes	No	No
New Mexico	Yes	No	No
New York	NR	NR	NR
North Carolina	No
North Dakota	No
Ohio	Yes	No	Per diem
Oklahoma	No
Oregon	Yes	No	No
Pennsylvania	No
Rhode Island	Yes	No	Yes - Not Specified
South Carolina	NR	NR	NR
South Dakota	Yes	5% of payment for mental health services.	40 hours therapy/year of all types in combination with other providers
Tennessee	Yes	No	No
Texas	Yes	No	Limited to 3 units per day
Utah	Yes	No	No
Vermont	Yes	No	No
Virginia	Yes	No	No
Washington	Yes	No	Some require prior authorization
West Virginia	Yes	No	PA Required
Wisconsin	Yes	$0.50-$3.00 per service	Prior authorization required.
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: Day Treatment

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Medicaid Behavioral Health Services: Day Treatment

2022

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