Medicaid Behavioral Health Services: Family Therapy

2022

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 45; No - 0; NR - 6	Yes - 9	Yes - 13
Alabama	Yes	Yes - not specified	No
Alaska	Yes	No	10 hour limit for any combination of psychotherapy services
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	Prior authorization is required after the first 160 hours of the service
Florida	Yes	$2	Limit of 104 quarter-hour units (26 hours) of individual and family therapy services per state fiscal year; maximum daily limit of 4 quarter-hour units (1 hour)
Georgia	NR	NR	NR
Hawaii	Yes	No	No
Idaho	Yes	No	No
Illinois	Yes	No	No
Indiana	Yes	No	NR
Iowa	Yes	No	No
Kansas	Yes	No	No
Kentucky	Yes	No	NR
Louisiana	Yes	No	NR
Maine	Yes	$.50 to $2 per day, depending on payment amount, up to $20 per month	Limit of 72 quarter-hour units per year, which can be extended when prior authorized based on medical necessity
Maryland	Yes	No	NR
Massachusetts	Yes	No	No
Michigan	Yes	No	No
Minnesota	NR	NR	NR
Mississippi	Yes	$3 for non-community mental health center outpatient setting	Limit of 1 visit per day and 24 visits per state fiscal year for outpatient providers; prior authorization is required for outpatient hospital settings
Missouri	Yes	Yes - not specified	No
Montana	Yes	No	No
Nebraska	Yes	$2	No
Nevada	Yes	No	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	Yes	No	Limit of 8 unmanaged visits per state fiscal year
North Dakota	Yes	No	No
Ohio	Yes	No	No
Oklahoma	Yes	$3	Limit of 2 hours per week of individual and/or family therapy combined
Oregon	Yes	No	Limit of 2 units per day
Pennsylvania	Yes	$.50 per unit of service	No
Rhode Island	Yes	No	No
South Carolina	Yes	No	Limit of 4 sessions per month
South Dakota	Yes	5% of allowable reimbursement	Limit of 40 hours of therapy in a state fiscal year when provided by an Independent Mental Health Provider; no limit for community mental health centers
Tennessee	Yes	No	No
Texas	Yes	No	Limit of 4 hours per person, per day, and 30 visits (individual, family or group therapy) per person, per calendar year; limits may be exceeded with prior authorization in increments of up to 10 additional visits; multi-family group psychotherapy and marriage and couples counseling are excluded
Utah	NR	NR	NR
Vermont	Yes	No	No
Virginia	Yes	No	No
Washington	Yes	No	No
West Virginia	Yes	No	Based on medical necessity
Wisconsin	Yes	No	No
Wyoming	Yes	No	No

2018

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 46 No - 0 NR - 5	Yes - 9	Yes - 20
Alabama	Yes	No	1 (minimum 60 minute episode) episode per day, 104 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	Should not be billed as part of an intermediate BH program such as intensive outpatient program (IOP) or partial hospitalization program (PHP).
Delaware	Yes	No	40 hrs per year
District of Columbia	Yes	No	No
Florida	Yes	$2.00 copayment per visit	Up to 26 hours per recipient, per fiscal year.
Georgia	Yes	No	No
Hawaii	Yes	No	No
Idaho	Yes	No	Not covered in fee for service but may be covered by contracted outpatient behavioral health plan
Illinois	NR	NR	NR
Indiana	Yes	No	20 units without PA
Iowa	NR	NR	NR
Kansas	Yes	No	No
Kentucky	Yes	Co Pay $3	Family therapy services shall be limited to a maximum of a combined three (3) hours per day, per recipient, which can be exceeded based on medical necessity.
Louisiana	Yes	No	NR
Maine	Yes	$.50 to $2/day depending on payment amount, up to $20/month	2 hours/week or 3 hours/week if interpreter needed or substance use related, no more than 30 weeks out of 40
Maryland	Yes	No	Services are pre-authorized
Massachusetts	Yes	No	No
Michigan	Yes	No	No
Minnesota	Yes	No	NR
Mississippi	Yes	No	Limited to 1 Daily, Maximum of 24 Yearly.
Missouri	Yes	$1 - $2	No
Montana	Yes	No	No
Nebraska	Yes	$2 copay	No
Nevada	Yes	No	Child and Adolescent: LOC 1, 10 Sessions; LOC 2-6, 26 sessions. Adults: LOC 1, 6 sessions; LOC 2-3, 12 sessions; LOC 4, 16 sessions; LOC 5 -6, 18 sessions. (Sessions include individual, group and/or family)
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 authorization required after 8 visits
North Dakota	Yes	$2 per visit	30 visits per year; limits are in conjunction with group and family therapy
Ohio	Yes	No	No
Oklahoma	Yes	$4 per visit	4 units per day per member. Cumulative max of 8 units of individual and family psychotherapy per week per member.
Oregon	Yes	No	No
Pennsylvania	Yes	No	Medical necessity
Rhode Island	Yes	No	No
South Carolina	NR	NR	NR
South Dakota	Yes	$3/visit	40 hours therapy/year of all types in combination with other providers
Tennessee	Yes	No	No
Texas	Yes	No	30 therapy sessions per year, 4 hour limit on outpatient services per day including therapy, prior authorization after limits are exceeded
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	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: Family Therapy

Data are loading

Medicaid Behavioral Health Services: Family Therapy

2022

2018

Topics

Categories