Medicaid Behavioral Health Services: Mental Health Clinic Services

2022

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 44; No - 1; NR - 6	Yes - 6	Yes - 8
Alabama	Yes	Yes - not specified	No
Alaska	Yes	No	NR
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	No
Florida	Yes	NR	NR
Georgia	NR	NR	NR
Hawaii	Yes	No	No
Idaho	Yes	No	NR
Illinois	No
Indiana	Yes	No	NR
Iowa	Yes	No	No
Kansas	Yes	No	No
Kentucky	Yes	No	NR
Louisiana	Yes	No	No
Maine	Yes	$.50 to $2 per day, depending on payment amount, up to $20 per month	Limits for underlying services apply
Maryland	Yes	No	NR
Massachusetts	Yes	No	No
Michigan	Yes	No	No
Minnesota	NR	NR	NR
Mississippi	Yes	$3	Limit of 1 per day for Federally Qualified Health Centers and Rural Health Clinics
Missouri	Yes	No	No
Montana	Yes	No	Requires prior authorization and continued stay reviews
Nebraska	Yes	Yes - not specified	No
Nevada	Yes	No	Requirements are based the individual services assessed
New Hampshire	NR	NR	NR
New Jersey	Yes	No	No
New Mexico	Yes	No	No
New York	Yes	No	No
North Carolina	Yes	No	Limits depend on service provided in clinic
North Dakota	Yes	No	No
Ohio	Yes	No	No
Oklahoma	Yes	$3	No
Oregon	Yes	No	Yes - varies by service
Pennsylvania	Yes	Yes - rates vary based on the fee for the service procedure code	No
Rhode Island	Yes	No	No
South Carolina	Yes	NR	NR
South Dakota	Yes	No	No
Tennessee	Yes	No	No
Texas	Yes	No	Yes - varies by service
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 - 43 No - 2 NR - 6	Yes - 9	Yes - 12
Alabama	No
Alaska	Yes	$3	No
Arizona	Yes	No	No
Arkansas	Yes	NR	NR
California	Yes	No	No
Colorado	Yes	No	No
Connecticut	Yes	No	NR
Delaware	Yes	No	Medically necessary and part of a treatment plan
District of Columbia	Yes	No	No
Florida	Yes	$2 per visit	Limits are indicated on the applicable fee schedules.
Georgia	No
Hawaii	Yes	No	No
Idaho	Yes	NR	NR
Illinois	NR	NR	NR
Indiana	Yes	No	20 units without PA
Iowa	NR	NR	NR
Kansas	Yes	$3 per visit	No
Kentucky	Yes	$3 copay	No
Louisiana	Yes	No	No
Maine	Yes	$.50 to $2/day depending on payment amount, up to $20/month	Limitations for underlying services apply
Maryland	Yes	No	Services are pre-authorized
Massachusetts	Yes	No	No
Michigan	Yes	No	No
Minnesota	Yes	No	NR
Mississippi	Yes	NR	NR
Missouri	Yes	No	No
Montana	Yes	No	Prior Authorization/Continued Stay Reviews
Nebraska	Yes	No	No
Nevada	Yes	No	Requirements are based on the individual services accessed.
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	No
Ohio	Yes	No	Yes - Not Specified
Oklahoma	Yes	$4 per visit	PA Required
Oregon	Yes	No	No
Pennsylvania	Yes	No	No
Rhode Island	Yes	No	No
South Carolina	NR	NR	NR
South Dakota	Yes	5% of payment for mental health services.	NR
Tennessee	Yes	No	No
Texas	Yes	No	Limits vary by service
Utah	Yes	No	No
Vermont	Yes	No	No
Virginia	Yes	No	No
Washington	NR	No	NR
West Virginia	Yes	No	No
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

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Medicaid Behavioral Health Services: Mental Health Clinic Services

2022

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