Medicaid Benefits: Targeted Case Management

This data is presented as an interactive tool that allows users to: filter by timeframe/year, select specific data columns (distributions), filter by state or geography, and view the data as a table, map, or trend chart.

2018

Location	Benefit Covered	Coverage Code	Copayment Required?	Limits on Services	Prior Approval Required	Reimbursement Methodology
United States	Yes - 36 No - 8 NR - 7	2018 data limited to CN	Yes - 2	Yes - 17	Included in "Limits on Services" for 2018	Not included in 2018 survey
Alabama	Yes	CN	No	No	-	-
Alaska	No				-	-
Arizona	Yes	CN	No	For Developmental Disabilities population	-	-
Arkansas	Yes	CN	NR	NR	-	-
California	Yes	CN	No	No	-	-
Colorado	Yes	CN	No	No	-	-
Connecticut	Yes	CN	No	Services provided in conjunction with the Department of Mental Health and Addiction Services and the member must be 18 or older.	-	-
Delaware	Yes	CN	No	Limited to pregnant women with prior authorization	-	-
District of Columbia	No				-	-
Florida	Yes	CN	No	Florida Medicaid reimburses for 344 15 minute units per recipient, per month of mental health TCM.	-	-
Georgia	Yes	CN	$3 copay	Limited to high risk populations.	-	-
Hawaii	Yes	CN	No	No	-	-
Idaho	No				-	-
Illinois	NR	NR	NR	NR	-	-
Indiana	No				-	-
Iowa	NR	NR	NR	NR	-	-
Kansas	Yes	CN	No	No	-	-
Kentucky	Yes	CN	No	Limits vary by service provided	-	-
Louisiana	Yes	CN	No	No	-	-
Maine	Yes	CN	No	No	-	-
Maryland	Yes	CN	No	Limits based on acuity	-	-
Massachusetts	Yes	CN	No	No	-	-
Michigan	Yes	CN	No	Limits apply for various groups.	-	-
Minnesota	Yes	CN	No	No	-	-
Mississippi	No				-	-
Missouri	Yes	CN	No	There are daily quantity limits on services.	-	-
Montana	Yes	CN	No	Limited to adults with substance use disorders, severe disabling mental illness, or high-risk pregnancies	-	-
Nebraska	No				-	-
Nevada	NR	NR	NR	NR	-	-
New Hampshire	NR	NR	NR	NR	-	-
New Jersey	Yes	CN	No	Limited to SMI	-	-
New Mexico	Yes	CN	No	No	-	-
New York	NR	NR	NR	NR	-	-
North Carolina	No				-	-
North Dakota	Yes	CN	No	Covered only for children in the welfare system, high-risk pregnant women, individuals accessing home and community-based services and individuals with SMI.	-	-
Ohio	Yes	CN	No	DD Waivers Only; See Section III Behavioral Health services	-	-
Oklahoma	Yes	CN	$4 per visit	Payment is made for services to persons with an intellectual disability and/or related conditions who are served by the Home and Community Based Waivers services/Developmental Disabilities Services Division or who reside in institutions. Provided to chronically and/or severely mentally ill members age 18 years and older who are at imminent risk of out-of-home placement due to psychiatric or substance abuse reasons. Provided by Health Homes for adults with severe mental illness (SMI).	-	-
Oregon	Yes	CN	No	No	-	-
Pennsylvania	Yes	CN	No	Limited to individuals in follow target groups: 1) Intellectual disability/autism; 2) High risk pregnancies; 3) AIDS or symptomatic HIV; 4) Children under the age of 3 with developmental delay; 5) Serious mental illness	-	-
Rhode Island	Yes	CN	No	No	-	-
South Carolina	NR	NR	NR	NR	-	-
South Dakota	No				-	-
Tennessee	Yes	CN	No	No	-	-
Texas	Yes	CN	No	No	-	-
Utah	Yes	CN	No	No	-	-
Vermont	Yes	CN	No	Limited to 3 adult target groups: persons with developmental disabilities unable to access needed medical, social, educational and other services because of adaptive deficits or lack of supports; families whose children are abused or neglected or suspected of being at imminent risk thereof and families of children receiving post adoption assistance; and certain pregnant and postpartum women and infants through 12 months of age	-	-
Virginia	NR	NR	NR	NR	-	-
Washington	Yes	CN	No	No	-	-
West Virginia	Yes	CN	No	NR	-	-
Wisconsin	Yes	CN	No	No	-	-
Wyoming	Yes	CN	No	Targeted case management services are only provided by state certified Community Mental Health Clinics or Substance Abuse Treatment Clinics	-	-

2012

Location	Benefit Covered	Coverage Code	Copayment Required?	Limit on services days	Prior Approval Required	Reimbursement Methodology
United States	Yes - 50 No - 6		Yes - 1 No - 49
Alabama	Yes	CN		Services provided for multiple populations - See service-specific FN		Negotiated rate
Alaska	Yes	CN		Quantity and frequency limits vary by group served		Fee for service
American Samoa	No
Arizona	Yes	CN & MN				Capitated rate
Arkansas	Yes	CN & MN		50 hours (200 units)/year		Fee for service, negotiated rate or cost based payment
California	Yes	CN & MN				Cost based payment
Colorado	Yes	CN		Limited to persons receiving substance abuse, behavioral health or nurse home visitor services (for first-time pregnant women) and to persons with developmental disabilities		Fee for service or negotiated rate
Connecticut	Yes	CN & MN				Negotiated rate
Delaware	No
District of Columbia	Yes	CN		Quantity limits vary by type of service		Fee for service
Florida	Yes	CN & MN		Quantity and frequency limits vary by service		Fee for service or contracted rate
Georgia	Yes	CN & MN		Quantity and frequency limits vary by group served		Fee for service or negotiated rate
Guam	No
Hawaii	Yes	CN & MN				Negotiated rate
Idaho	Yes	CN		Services limited to Enhanced Plan, quantity and frequency limits vary by group served	Yes	Fee for service
Illinois	Yes	CN & MN		Quantity and frequency limits vary by group served		Fee for service
Indiana	No
Iowa	Yes	CN & MN			Specified services	Prospective cost based rate
Kansas	Yes	CN & MN				Reasonable charge
Kentucky	Yes	A, B & C - See state-specific FN				Cost based payment
Louisiana	Yes	CN & MN				Fee for service or monthly rate
Maine	Yes	CN & MN		Coverage limitations vary by service and provider		Fee for service
Maryland	Yes	CN & MN				Fee for service
Massachusetts	Yes	CN & MN				Fee for service or negotiated rate
Michigan	Yes	CN & MN				Fee for service or capitated rate
Minnesota	Yes	A & B - See state-specific FN		B - limited to mental health conditions		Fee for service, cost based payment or negotiated rate
Mississippi	Yes	CN				Fee for service or negotiated rate
Missouri	Yes	CN	$1/day			Fee for service
Montana	Yes	A & B - See state-specific FN				Fee for service
Nebraska	Yes	CN & MN				Fee for service
Nevada	Yes	CN		Criteria must be met for one of the target groups		Prospective cost based rate
New Hampshire	Yes	CN & MN				Fee for service or cost based payment
New Jersey	Yes	CN & MN - See state-specific FN				Fee for service
New Mexico	Yes	CN				Fee for service
New York	Yes	CN & MN				Fee for service
North Carolina	Yes	CN & MN				Fee for service
North Dakota	Yes	CN & MN				Fee for service
Northern Mariana Islands	No
Ohio	Yes	CN				Fee for service
Oklahoma	Yes	CN		Quantity and frequency limits vary by group served		Fee for service
Oregon	Yes	A - See state-specific FN				Fee for service or cost based payment
Pennsylvania	Yes	CN & MN		Varies by targeted group		Fee for service
Puerto Rico	Yes	CN & MN		Limited to services rendered by health plan staff		Service is included in the capitated rate paid to managed care plans
Rhode Island	Yes	See state-specific FN				Fee for service
South Carolina	Yes	CN				Cost based payment
South Dakota	Yes	CN				Prospective cost based rate
Tennessee	Yes	A - See state-specific FN				See state-specific FN
Texas	Yes	CN & MN		Multiple populations served, including persons with chronic mental illness, intellectual disability, or visual impairment, high risk pregnant women and infants/toddlers with developmental delays	Yes	Cost based payment
Utah	Yes	A & B - See state-specific FN				Fee for service
Vermont	Yes	A & B - See state-specific FN				Fee for service or cost based payment
U.S. Virgin Islands	No
Virginia	Yes	CN & MN		Limits vary by population group served	Selected services	Fee for service
Washington	Yes	CN & MN		Coverage parameters vary by condition and need		Fee for service, capitated rate or cost based payment
West Virginia	Yes	A, B & C			Yes	Fee for service
Wisconsin	Yes	CN & MN				Fee for service
Wyoming	Yes	CN			Yes	Fee for service

2010

Location	Benefit Covered	Coverage Code	Copayment Required?	Limit on services days	Prior Approval Required	Reimbursement Methodology
United States	Yes - 51 No - 5		Yes - 1 No - 50
Alabama	Yes	CN		Services provided for multiple populations - See service-specific FN		Negotiated rate
Alaska	Yes	CN		Quantity and frequency limits vary by group served		Fee for service
American Samoa	No
Arizona	Yes	CN & MN				Capitated rate
Arkansas	Yes	CN & MN				Fee for service, negotiated rate or cost based payment
California	Yes	CN & MN				Cost based payment
Colorado	Yes	CN		Limited to persons receiving substance abuse, behavioral health or nurse home visitor services (for first-time pregnant women) and to persons with developmental disabilities		Fee for service or negotiated rate
Connecticut	Yes	CN & MN				Negotiated rate
Delaware	No
District of Columbia	Yes	CN		Quantity limits vary by type of service		Fee for service
Florida	Yes	CN & MN		Quantity and frequency limits vary by service		Fee for service or contracted rate
Georgia	Yes	CN & MN		Quantity and frequency limits vary by group served		Fee for service or negotiated rate
Guam	No
Hawaii	Yes	CN & MN				Negotiated rate
Idaho	Yes	CN		Services limited to Enhanced Plan, quantity and frequency limits vary by group served	Yes	Fee for service
Illinois	Yes	CN & MN		Quantity and frequency limits vary by group served		Fee for service
Indiana	Yes	CN		Quantity and frequency limits vary by group served		Fee for service
Iowa	Yes	CN & MN			Specified services	Prospective cost based rate
Kansas	Yes	CN & MN				Reasonable charge
Kentucky	Yes	A, B & C - See state-specific FN				Cost based payment
Louisiana	Yes	CN & MN				Fee for service or monthly rate
Maine	Yes	CN & MN		Coverage limitations vary by service and provider		Fee for service
Maryland	Yes	CN & MN				Fee for service
Massachusetts	Yes	CN & MN				Fee for service or negotiated rate
Michigan	Yes	CN & MN				Fee for service or capitated rate
Minnesota	Yes	A & B - See state-specific FN		B - limited to mental health conditions		Fee for service, cost based payment or negotiated rate
Mississippi	Yes	CN				Fee for service or negotiated rate
Missouri	Yes	CN	$1/day			Fee for service
Montana	Yes	A & B - See state-specific FN				Fee for service
Nebraska	Yes	CN & MN				Fee for service
Nevada	Yes	CN		Criteria must be met for one of the target groups		Prospective cost based rate
New Hampshire	Yes	CN & MN				Fee for service or cost based payment
New Jersey	Yes	CN & MN - See state-specific FN				Fee for service
New Mexico	Yes	CN				Fee for service
New York	Yes	CN & MN				Fee for service
North Carolina	Yes	CN & MN				Fee for service
North Dakota	Yes	CN & MN				Fee for service
Northern Mariana Islands	No
Ohio	Yes	CN				Fee for service
Oklahoma	Yes	CN		Quantity and frequency limits vary by group served		Fee for service
Oregon	Yes	A - See state-specific FN				Fee for service or cost based payment
Pennsylvania	Yes	CN & MN		Varies by targeted group		Fee for service
Puerto Rico	Yes	CN & MN		Limited to services rendered by health plan staff		Service is included in the capitated rate paid to managed care plans
Rhode Island	Yes	See state-specific FN				Fee for service
South Carolina	Yes	CN				Cost based payment
South Dakota	Yes	CN				Prospective cost based rate
Tennessee	Yes	A & B - See state-specific FN				See state-specific FN
Texas	Yes	CN & MN			Yes	Cost based payment
Utah	Yes	A & B - See state-specific FN				Fee for service
Vermont	Yes	A & B - See state-specific FN				Fee for service or cost based payment
U.S. Virgin Islands	No
Virginia	Yes	CN & MN		Limits vary by population group served		Fee for service
Washington	Yes	CN & MN		Coverage parameters vary by condition and need		Fee for service, capitated rate or cost based payment
West Virginia	Yes	A, B & C			Yes	Fee for service or other rate depending on provider
Wisconsin	Yes	CN & MN				Fee for service
Wyoming	Yes	CN				Fee for service

2008

Location	Benefit Covered	Coverage Code	Copayment Required?	Limit on services days	Prior Approval Required	Reimbursement Methodology
United States	Yes - 51 No - 5		Yes - 1 No - 50
Alabama	Yes	CN		Services provided for multiple populations - See service-specific FN		Negotiated rate
Alaska	Yes	CN				Fee for service
American Samoa	No
Arizona	Yes	CN & MN				Capitated rate
Arkansas	Yes	CN & MN				Fee for service, negotiated rate or cost based payment
California	Yes	CN & MN				Cost based payment
Colorado	Yes	CN				Fee for service or negotiated rate
Connecticut	Yes	CN & MN				Negotiated rate
Delaware	No
District of Columbia	Yes	CN & MN		Quantity limits vary by type of service		Fee for service
Florida	Yes	CN & MN		Quantity and frequency limits vary by service		Fee for service or contracted rate
Georgia	Yes	CN & MN		Quantity and frequency limits vary by group served		Fee for service or negotiated rate
Guam	No
Hawaii	Yes	CN & MN				Negotiated rate
Idaho	Yes	CN		Services limited to Enhanced Plan, quantity and frequency limits vary by group served	Yes	Fee for service
Illinois	Yes	CN & MN		Quantity and frequency limits vary by group served		Fee for service
Indiana	Yes	CN		Quantity and frequency limits vary by group served		Fee for service
Iowa	Yes	CN & MN			Specified services	Prospective cost based rate
Kansas	Yes	CN & MN				Reasonable charge
Kentucky	Yes	A, B & C - See state-specific FN				Cost based payment
Louisiana	Yes	CN & MN				Fee for service or monthly rate
Maine	Yes	CN & MN		Coverage limitations vary by setting and provider		Negotiated rate
Maryland	Yes	CN & MN				Fee for service
Massachusetts	Yes	CN & MN				Fee for service or negotiated rate
Michigan	Yes	CN & MN				Fee for service or capitated rate
Minnesota	Yes	A & B - See state-specific FN		B - limited to mental health conditions		Fee for service, cost based payment or negotiated rate
Mississippi	Yes	CN				Fee for service or negotiated rate
Missouri	Yes	CN	$1/day			Fee for service
Montana	Yes	A & B - See state-specific FN				Fee for service
Nebraska	Yes	CN & MN				Fee for service
Nevada	Yes	CN				Prospective cost based rate
New Hampshire	Yes	CN & MN				Fee for service or cost based payment
New Jersey	Yes	CN & MN - See state-specific FN				Fee for service
New Mexico	Yes	CN				Fee for service
New York	Yes	CN & MN				Fee for service
North Carolina	Yes	CN & MN				Fee for service
North Dakota	Yes	CN & MN				Fee for service
Northern Mariana Islands	No
Ohio	Yes	CN				Fee for service
Oklahoma	Yes	CN		Quantity and frequency limits vary by group served		Fee for service
Oregon	Yes	A - See state-specific FN				Fee for service or cost based payment
Pennsylvania	Yes	CN & MN		Varies by targeted group		Fee for service
Puerto Rico	Yes	CN & MN		Limited to services rendered by health plan staff		Capitated payment
Rhode Island	Yes	CN & MN - see state-specific FN				Fee for service
South Carolina	Yes	CN				Cost based payment
South Dakota	Yes	CN				Prospective cost based rate
Tennessee	Yes	A & B - See state-specific FN
Texas	Yes	CN & MN			Yes	Cost based payment
Utah	Yes	A & B - See state-specific FN				Fee for service
Vermont	Yes	A & B - See state-specific FN				Fee for service or cost based payment
U.S. Virgin Islands	No
Virginia	Yes	CN & MN		Limits vary by population group served		Fee for service
Washington	Yes	CN & MN		Coverage parameters vary by condition and need		Fee for service, capitated rate or cost based payment
West Virginia	Yes	B &C		Dependent upon population served	Yes	Fee for service or other rate depending on provider
Wisconsin	Yes	CN & MN				Fee for service
Wyoming	Yes	CN				Fee for service

2006

Location	Benefit Covered	Coverage Code	Copayment Required?	Limit on services days	Prior Approval Required	Reimbursement Methodology
United States	Yes - 51 No - 5		Yes - 1 No - 50
Alabama	Yes	CN		Services provided for multiple populations - See service-specific FN		Negotiated rate
Alaska	Yes	CN				Fee for service
American Samoa	No
Arizona	Yes	CN & MN		Coverage limited to Developmentally Disabled - coverage parameters vary between Acute Care and ALTCS program - see state-specific FN		Capitated rate
Arkansas	Yes	CN & MN				Fee for service, negotiated rate or cost based payment
California	Yes	CN & MN				Cost based payment
Colorado	Yes	CN				Fee for service or negotiated rate
Connecticut	Yes	CN & MN				Negotiated rate
Delaware	No
District of Columbia	Yes	CN & MN		Quantity limits vary by type of service		Fee for service
Florida	Yes	CN & MN				Fee for service or contracted rate
Georgia	Yes	CN & MN		Quantity and frequency limits vary by group served		Fee for service or negotiated rate
Guam	No
Hawaii	Yes	CN & MN				Negotiated rate
Idaho	Yes	CN		Quantity and frequency limits vary by group served - certain groups covered only through Enhanced Plan	Yes	Fee for service
Illinois	Yes	CN & MN		Quantity and frequency limits vary by group served		Fee for service
Indiana	Yes	CN		Quantity and frequency limits vary by group served		Fee for service
Iowa	Yes	CN & MN			Specified services	Prospective cost based rate
Kansas	Yes	CN & MN				Reasonable charge
Kentucky	Yes	A, B & C - See state-specific FN				Cost based payment
Louisiana	Yes	CN & MN				Fixed or negotiated rate
Maine	Yes	CN & MN		Coverage limitations vary by setting and provider		Negotiated rate
Maryland	Yes	CN & MN				Fee for service
Massachusetts	Yes	CN & MN				Fee for service or negotiated rate
Michigan	Yes	CN & MN				Fee for service or capitated rate
Minnesota	Yes	A - See state-specific FN				Fee for service, cost based payment or negotiated rate
Mississippi	Yes	CN				Fee for service or negotiated rate
Missouri	Yes	CN	$1/day			Fee for service
Montana	Yes	A & B - See state-specific FN				Fee for service
Nebraska	Yes	CN & MN				Fee for service
Nevada	Yes	CN				Prospective cost based rate
New Hampshire	Yes	CN & MN				Fee for service or cost based payment
New Jersey	Yes	CN & MN - See state-specific FN				Fee for service
New Mexico	Yes	CN				Fee for service
New York	Yes	CN & MN				Prospective cost based rate
North Carolina	Yes	CN & MN				Fee for service, negotiated rate or cost based payment
North Dakota	Yes	CN & MN				Fee for service
Northern Mariana Islands	No
Ohio	Yes	CN				Fee for service
Oklahoma	Yes	CN		Quantity and frequency limits vary by group served		Fee for service
Oregon	Yes	A - See state-specific FN				Fee for service or cost based payment
Pennsylvania	Yes	CN & MN				Fee for service
Puerto Rico	Yes	CN & MN		Limited to services rendered by health plan staff		Capitated payment
Rhode Island	Yes	CN & MN - see state-specific FN				Fee for service
South Carolina	Yes	CN				Fee for service
South Dakota	Yes	CN				Prospective cost based rate
Tennessee	Yes	A & B - See state-specific FN
Texas	Yes	CN & MN			Yes	Fee for service
Utah	Yes	A & B - See state-specific FN				Fee for service
Vermont	Yes	A & B - See state-specific FN				Fee for service or cost based payment
U.S. Virgin Islands	No
Virginia	Yes	CN & MN				Fee for service
Washington	Yes	CN & MN		Coverage parameters vary by condition and need		Fee for service, capitated rate or cost based payment
West Virginia	Yes	CN & MN		Dependent upon population served	Yes	Fee for service or other rate depending on provider
Wisconsin	Yes	CN & MN				Fee for service, per diem or percentage of charge
Wyoming	Yes	CN				Fee for service

2004

Location	Benefit Covered	Coverage Code	Copayment Required?	Limit on services days	Prior Approval Required	Reimbursement Methodology
United States	Yes - 51 No - 5		Yes - 0 No - 51
Alabama	Yes	CN				Negotiated rate
Alaska	Yes	CN				Fee for service
American Samoa	No
Arizona	Yes	CN & MN		Coverage limited to Developmentally Disabled - coverage parameters vary between Acute Care and ALTCS program - see state-specific FN		Capitated rate
Arkansas	Yes	CN & MN				Fee for service, negotiated rate or cost based payment
California	Yes	CN & MN				Cost based payment
Colorado	Yes	CN				Fee for service or negotiated rate
Connecticut	Yes	CN & MN				Negotiated rate
Delaware	No
District of Columbia	Yes	CN & MN		Quantity limits vary by type of service		Fee for service
Florida	Yes	CN & MN				Fee for service or contracted rate
Georgia	Yes	CN & MN		Quantity and frequency limits vary by group served		Fee for service or negotiated rate
Guam	No
Hawaii	Yes	CN & MN				Negotiated rate
Idaho	Yes	CN		Quantity and frequency limits vary by group served	Yes	Fee for service
Illinois	Yes	CN & MN		Quantity and frequency limits vary by group served		Fee for service
Indiana	Yes	CN		Quantity and frequency limits vary by group served		Fee for service
Iowa	Yes	CN & MN			Specified services	Prospective cost based rate
Kansas	Yes	CN & MN				Reasonable charge
Kentucky	Yes	CN & MN				Cost based payment
Louisiana	Yes	CN & MN				Fixed or negotiated rate
Maine	Yes	CN & MN				Negotiated rate
Maryland	Yes	CN & MN				Fee for service
Massachusetts	Yes	CN & MN				Fee for service or negotiated rate
Michigan	Yes	CN & MN				Fee for service or capitated rate
Minnesota	Yes	A - See state-specific FN				Fee for service, cost based payment or negotiated rate
Mississippi	Yes	CN				Fee for service or negotiated rate
Missouri	Yes	CN				Fee for service
Montana	Yes	A & B - See state-specific FN				Fee for service
Nebraska	Yes	CN & MN				Fee for service
Nevada	Yes	CN				Prospective cost based rate
New Hampshire	Yes	CN & MN				Fee for service or cost based payment
New Jersey	Yes	CN & MN - See state-specific FN				Fee for service
New Mexico	Yes	CN				Fee for service
New York	Yes	CN & MN				Prospective cost based rate
North Carolina	Yes	CN & MN				Fee for service, negotiated rate or cost based payment
North Dakota	Yes	CN & MN				Fee for service
Northern Mariana Islands	No
Ohio	Yes	CN				Fee for service
Oklahoma	Yes	CN		Quantity and frequency limits vary by group served		Fee for service
Oregon	Yes	A - See state-specific FN				Fee for service or cost based payment
Pennsylvania	Yes	CN & MN				Fee for service
Puerto Rico	Yes	CN & MN		Limited to services rendered by health plan staff		Capitated payment
Rhode Island	Yes	CN & MN - see state-specific FN				Fee for service
South Carolina	Yes	CN				Fee for service
South Dakota	Yes	CN				Prospective cost based rate
Tennessee	Yes	A & B - See state-specific FN
Texas	Yes	CN & MN			Yes	Fee for service
Utah	Yes	A & B - See state-specific FN				Fee for service
Vermont	Yes	A & B - See state-specific FN				Fee for service or cost based payment
U.S. Virgin Islands	No
Virginia	Yes	CN & MN				Fee for service
Washington	Yes	CN & MN		Coverage parameters vary by condition and need		Fee for service, capitated rate or cost based payment
West Virginia	Yes	CN & MN		Dependent upon population served	Yes	Fee for service or other rate depending on provider
Wisconsin	Yes	CN & MN				Fee for service, per diem or percentage of charge
Wyoming	Yes	CN				Fee for service

2003

Location	Benefit Covered	Coverage Code	Copayment Required?	Limit on services days	Prior Approval Required	Reimbursement Methodology
United States	Yes - 51 No - 5		Yes - 0 No - 51
Alabama	Yes	CN				Negotiated rate
Alaska	Yes	CN				Fee for service
American Samoa	No
Arizona	Yes	CN & MN		Coverage limited to Developmentally Disabled - coverage parameters vary between Acute Care and ALTCS program - see state-specific FN		Capitated rate
Arkansas	Yes	CN & MN				Fee for service, negotiated rate or cost based payment
California	Yes	CN & MN				Cost based payment
Colorado	Yes	CN				Fee for service or negotiated rate
Connecticut	Yes	CN & MN				Negotiated rate
Delaware	No
District of Columbia	Yes	CN & MN		Quantity limits vary by type of service		Fee for service
Florida	Yes	CN & MN				Fee for service or contracted rate
Georgia	Yes	CN & MN		Quantity and frequency limits vary by group served		Fee for service or negotiated rate
Guam	No
Hawaii	Yes	CN & MN				Negotiated rate
Idaho	Yes	CN		Quantity and frequency limits vary by group served	Yes	Fee for service
Illinois	Yes	CN & MN		Quantity and frequency limits vary by group served		Fee for service
Indiana	Yes	CN		Quantity and frequency limits vary by group served		Fee for service
Iowa	Yes	CN & MN			Specified services	Prospective cost based rate
Kansas	Yes	CN & MN				Reasonable charge
Kentucky	Yes	CN & MN				Cost based payment
Louisiana	Yes	CN & MN				Fixed or negotiated rate
Maine	Yes	CN & MN				Negotiated rate
Maryland	Yes	CN & MN				Fee for service
Massachusetts	Yes	CN & MN				Fee for service or negotiated rate
Michigan	Yes	CN & MN				Fee for service or capitated rate
Minnesota	Yes	A - See state-specific FN				Fee for service, cost based payment or negotiated rate
Mississippi	Yes	CN				Fee for service or negotiated rate
Missouri	Yes	CN				Fee for service
Montana	Yes	CN & MN				Fee for service
Nebraska	Yes	CN & MN				Fee for service
Nevada	Yes	CN				Prospective cost based rate
New Hampshire	Yes	CN & MN				Fee for service or cost based payment
New Jersey	Yes	CN & MN - See state-specific FN				Fee for service
New Mexico	Yes	CN				Fee for service
New York	Yes	CN & MN				Prospective cost based rate
North Carolina	Yes	CN & MN				Fee for service, negotiated rate or cost based payment
North Dakota	Yes	CN & MN				Fee for service
Northern Mariana Islands	No
Ohio	Yes	CN				Fee for service
Oklahoma	Yes	CN & MN		Quantity and frequency limits vary by group served		Fee for service
Oregon	Yes	CN & MN				Fee for service or cost based payment
Pennsylvania	Yes	CN & MN				Fee for service
Puerto Rico	Yes	CN & MN		Limited to services rendered by health plan staff		Capitated payment
Rhode Island	Yes	CN & MN - see state-specific FN				Fee for service
South Carolina	Yes	CN				Fee for service
South Dakota	Yes	CN				Prospective cost based rate
Tennessee	Yes	A & B - See state-specific FN
Texas	Yes	CN & MN			Yes	Fee for service or cost based payment
Utah	Yes	A & B - See state specific FN				Fee for service
Vermont	Yes	A & B - See state-specific FN				Fee for service or cost based payment
U.S. Virgin Islands	No
Virginia	Yes	CN & MN				Fee for service
Washington	Yes	CN & MN		Coverage parameters vary by condition and need		Fee for service, capitated rate or cost based payment
West Virginia	Yes	CN & MN				Prospective cost based rate
Wisconsin	Yes	CN & MN				Fee for service, per diem or percentage of charge
Wyoming	Yes	CN				Fee for service

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Medicaid Benefits: Targeted Case Management

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Medicaid Benefits: Targeted Case Management

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