Medicaid Behavioral Health Services: Mental Health Rehabilitation

2022

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 40; No - 5; NR - 6	Yes - 3	Yes - 10
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	No
Delaware	NR	NR	NR
District of Columbia	Yes	No	Yes - varies by service
Florida	Yes	$2	Yes - not specified
Georgia	NR	NR	NR
Hawaii	Yes	No	No
Idaho	Yes	No	NR
Illinois	Yes	No	No
Indiana	No
Iowa	Yes	No	No
Kansas	Yes	No	No
Kentucky	Yes	No	NR
Louisiana	Yes	No	For mental health rehabilitation, requires a certain score on the standardized assessment tool
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	Limit of 2 hours per day per individual
Nebraska	Yes	No	No
Nevada	Yes	No	NR
New Hampshire	NR	NR	NR
New Jersey	Yes	No	No
New Mexico	Yes	No	No
New York	Yes	No	No
North Carolina	Yes	No	For Community Support Team: 30 day pass through once per treatment episode, once per state fiscal year; then 128 units for 60 days unless searching for stable housing then up to 420 units per initial authorization; up to 192 for subsequent authorizations
North Dakota	Yes	No	No
Ohio	Yes	No	No
Oklahoma	Yes	$3	No
Oregon	Yes	No	No
Pennsylvania	No
Rhode Island	Yes	No	No
South Carolina	No
South Dakota	Yes	No	Must have SMI diagnosis
Tennessee	Yes	No	No
Texas	Yes	No	Available to adults with an SMI diagnosis who have been determined via a uniform assessment protocol to need the services; must be reauthorized every 180 calendar days for person 21 years of age and older and every 90 calendar days for persons 18-20 years of age
Utah	NR	NR	NR
Vermont	Yes	No	Beneficiaries receiving Community Rehabilitation and Treatment (CRT) services under the Section 1115 waiver are ineligible
Virginia	Yes	No	Service authorization is required
Washington	Yes	No	No
West Virginia	Yes	No	NR
Wisconsin	Yes	No	Provided in the context of psychosocial rehab programs that have functional eligiblity requirements
Wyoming	Yes	No	No

2018

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 37 No - 8 NR - 6	Yes - 2	Yes - 12
Alabama	Yes	No	No
Alaska	Yes	No	No
Arizona	Yes	No	No
Arkansas	Yes	NR	NR
California	Yes	No	No
Colorado	Yes	No	No
Connecticut	No
Delaware	Yes	No	Medically necessary and part of a treatment plan
District of Columbia	Yes	No	All Rehab Services have Prior Authorizations, Minimum and Maximum Limits, and have to meet medical necessity as described for LOCUS and ASAM Criteria. The maximums for residential treatment are 30 days per calendar month, outpatient treatment requires authorization after 180 days. Medication management requires med review every 90 days. Minimums vary per level of care depending on treatment plan.
Florida	No
Georgia	Yes	No	No
Hawaii	Yes	No	No
Idaho	No
Illinois	NR	NR	NR
Indiana	No
Iowa	NR	NR	NR
Kansas	Yes	No	No
Kentucky	No
Louisiana	Yes	No	Yes - Not Specified
Maine	Yes	No	No
Maryland	Yes	No	Services are pre-authorized
Massachusetts	Yes	No	No
Michigan	Yes	No	No
Minnesota	Yes	No	NR
Mississippi	NR	NR	NR
Missouri	Yes	No	No
Montana	Yes	No	2 hour per day individual/2 hour per day group limit with exceptions
Nebraska	Yes	No	No
Nevada	Yes	No	Yes - Not Specified
New Hampshire	NR	NR	NR
New Jersey	Yes	No	No
New Mexico	No
New York	NR	NR	NR
North Carolina	Yes	No	NR
North Dakota	Yes	No	Limited to individuals in families that are in crisis with risk of major disruption, to individuals who are at risk of entering or reentering a mental health or hospital facility, services provided by Human Service Center staff that are not otherwise Other Licensed Practitioners, in settings outside the Center, and services provided to individuals who have discharged from inpatient psychiatric treatment.
Ohio	Yes	No	No
Oklahoma	Yes	$4 per visit	PSR services for adults are limited to members who have a history of psychiatric hospitalization or admission to crisis centers, have been disabled by the SSA for mental health reasons, are residing in residential care facilities or are receiving services through a specialty court program.
Oregon	Yes	No	No
Pennsylvania	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	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	Beneficiaries receiving Community Rehabilitation and Treatment (CRT) services under the 1115 waiver are ineligible
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: Mental Health Rehabilitation

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Medicaid Behavioral Health Services: Mental Health Rehabilitation

2022

2018

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