Medicaid Behavioral Health Services: Inpatient Psychiatric Hospital

2022

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 39; No - 6; NR - 6	Yes - 7	Yes - 15
Alabama	Yes	Yes - not specified	No
Alaska	No
Arizona	Yes	NR	Yes - not specified
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 sometimes required
Florida	Yes	No	Limit of 45 days per year
Georgia	NR	NR	NR
Hawaii	Yes	No	No
Idaho	Yes	No	No
Illinois	Yes	No	Prior authorization required
Indiana	No
Iowa	Yes	No	No
Kansas	Yes	No	No
Kentucky	No
Louisiana	No
Maine	Yes	No	No
Maryland	Yes	No	Global average length of stay must not exceed 30 days
Massachusetts	Yes	No	No
Michigan	Yes	No	No
Minnesota	NR	NR	NR
Mississippi	No
Missouri	Yes	Yes - not specified	No
Montana	Yes	No	Requires prior authorization and continued stay reviews
Nebraska	Yes	No	No
Nevada	No
New Hampshire	NR	NR	NR
New Jersey	Yes	No	No
New Mexico	Yes	No	Prior authorization is required
New York	Yes	$25 copay for each hospitalization of any length involving at least 1 overnight stay	No
North Carolina	Yes	No	Prior authorization is required within 48 hours of observation
North Dakota	Yes	No	ND does not have an IMD waiver, so inpatient psychiatric services at a standalone psychiatric hospital may only be provided to individuals <21 or >64.
Ohio	Yes	No	Pre-certification required
Oklahoma	Yes	$10 per day, $75 maximum	Per IMD waiver, if services are furnished in IMD, only stays of 60 days or less are Medicaid compensable
Oregon	Yes	No	No
Pennsylvania	Yes	$3 per day, not to exceed $21 per admission	Concurrent and retrospective reviews
Rhode Island	Yes	No	No
South Carolina	Yes	$25 for inpatient hospital	Yes - not specified
South Dakota	Yes	$50 per admission	NR
Tennessee	Yes	No	No
Texas	Yes	No	65 and older only
Utah	NR	NR	NR
Vermont	Yes	No	No
Virginia	Yes	No	No
Washington	Yes	No	No
West Virginia	Yes	No	Limit of 15 calendar days
Wisconsin	Yes	No	NR
Wyoming	Yes	No	No

2018

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 43 No - 3 NR - 5	Yes - 4	Yes - 17
Alabama	No
Alaska	Yes	No	No
Arizona	Yes	No	15 day limitation per month
Arkansas	Yes	NR	NR
California	Yes	No	No
Colorado	Yes	No	No
Connecticut	Yes	No	Prior authorization required
Delaware	Yes	No	5 evaluations per year
District of Columbia	No
Florida	Yes	No	Up to 45 days per fiscal year for recipients age 21 years or older. Florida Medicaid reimburses for inpatient hospital days beyond the 45 day limit for emergency services, as defined in Rule 59G-1.010, F.A.C.
Georgia	Yes	No	No
Hawaii	Yes	No	No
Idaho	Yes	No	No
Illinois	NR	NR	NR
Indiana	Yes	No	Prior authorization required
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	Yes	No	Prior authorization required
Missouri	Yes	$10	No
Montana	Yes	No	No
Nebraska	Yes	No	No
Nevada	Yes	No	NR
New Hampshire	NR	NR	NR
New Jersey	Yes	No	No
New Mexico	Yes	No	Prior authorization required
New York	NR	NR	NR
North Carolina	Yes	No	Prior authorization required within 48 hours of admission
North Dakota	Yes	$75 per visit	Coverage is limited to individuals younger than 21 years of age and to those age 65 or older
Ohio	Yes	No	No
Oklahoma	Yes	$7.50 per day, up to a max of $75	Prior authorization required; can only be served in a psychiatric unit of a general hospital
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	Yes	NR	NR
Tennessee	Yes	No	No
Texas	Yes	No	65 and older only
Utah	Yes	No	No
Vermont	Yes	No	No
Virginia	Yes	No	No
Washington	Yes	No	Prior authorization for admissions and concurrent review for length of stay to confirm medical necessity
West Virginia	Yes	NR	NR
Wisconsin	Yes	$3.00 per day ($75 per stay)	Limited for IMD residents age 21 to 64
Wyoming	Yes	No	Prior authorization required

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Medicaid Behavioral Health Services: Inpatient Psychiatric Hospital

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Medicaid Behavioral Health Services: Inpatient Psychiatric Hospital

2022

2018

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