Medicaid Behavioral Health Services: Partial Hospitalization

2022

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 35; No - 10; 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	No
Colorado	Yes	No	No
Connecticut	Yes	No	No
Delaware	NR	NR	NR
District of Columbia	Yes	No	NR
Florida	No
Georgia	NR	NR	NR
Hawaii	Yes	No	No
Idaho	Yes	No	No
Illinois	Yes	No	No
Indiana	Yes	No	Prior authorization 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	Yes	$3 for outpatient hospital	100 per state fiscal year for community mental health centers; no limit in Outpatient Hospital; prior authorization is required for both settings
Missouri	No
Montana	Yes	No	No
Nebraska	Yes	No	No
Nevada	Yes	No	Prior authorization is required
New Hampshire	NR	NR	NR
New Jersey	Yes	No	Limit of 5 hours per day, 5 days per week
New Mexico	Yes	No	Prior authorization is required 45 days from admission
New York	Yes	No	No
North Carolina	Yes	No	Prior authorization is required
North Dakota	Yes	No	No
Ohio	Yes	No	Prior authorization is required for Substance Use Disorder Partial Hospitalization
Oklahoma	Yes	$3	No
Oregon	Yes	No	NR
Pennsylvania	Yes	No	No
Rhode Island	Yes	No	No
South Carolina	No
South Dakota	No
Tennessee	Yes	No	No
Texas	No
Utah	NR	NR	NR
Vermont	Yes	No	No
Virginia	Yes	No	Service authorization is required
Washington	No
West Virginia	Yes	No	Based on medical necessity
Wisconsin	Yes	No	Yes - not specified
Wyoming	No

2018

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 33 No - 13 NR - 5	Yes - 3	Yes - 12
Alabama	Yes	No	A minimum of 4 hours Maximum Units: A minimum of 4 hours per day, 130 days per year
Alaska	Yes	Inpatient $5 a day up to $200	No
Arizona	Yes	No	No
Arkansas	Yes	NR	NR
California	No
Colorado	Yes	No	No
Connecticut	Yes	No	At least 4 hours of structured programming 3-5 days per week with a minimum of 3.5 hours documented clinical services each day.
Delaware	Yes	No	No
District of Columbia	Yes	No	No
Florida	No
Georgia	No
Hawaii	Yes	No	No
Idaho	No
Illinois	NR	NR	NR
Indiana	Yes	No	Prior authorization required
Iowa	NR	NR	NR
Kansas	No
Kentucky	Yes	Co Pay $3	No
Louisiana	Yes	No	NR
Maine	Yes	No	No
Maryland	Yes	No	Services are pre-authorized
Massachusetts	No
Michigan	Yes	No	No
Minnesota	Yes	No	NR
Mississippi	Yes	No	Requires prior authorization and Limited to 1 Daily, Maximum of 100 Yearly.
Missouri	No
Montana	Yes	No	No
Nebraska	Yes	No	No
Nevada	Yes	No	PA required.
New Hampshire	NR	NR	NR
New Jersey	Yes	No	5 hrs per day, 5 days per week
New Mexico	Yes	No	No
New York	NR	NR	NR
North Carolina	Yes	No	Prior authorization required on the first day of service
North Dakota	Yes	No	45 days per year for Level A services (>4 hours per day); 30 days per year for Level B services (2-4 hours per day)
Ohio	No
Oklahoma	No
Oregon	Yes	No	No
Pennsylvania	Yes	No	No arbitrary treatment limits. Utilization management based on medical necessity.
Rhode Island	Yes	No	No
South Carolina	NR	NR	NR
South Dakota	No
Tennessee	Yes	No	No
Texas	No
Utah	Yes	No	No
Vermont	Yes	No	No
Virginia	Yes	No	No
Washington	No
West Virginia	Yes	No	PA Required
Wisconsin	Yes	$0.50-$3.00 per service	Prior authorization required.
Wyoming	No

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Medicaid Behavioral Health Services: Partial Hospitalization

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Medicaid Behavioral Health Services: Partial Hospitalization

2022

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