Medicaid Behavioral Health Services: Collaborative Care Model Services

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 19; No - 26; NR - 6	Yes - 0	Yes - 4
Alabama	No
Alaska	No
Arizona	Yes	NR	No
Arkansas	NR	NR	NR
California	No
Colorado	No
Connecticut	No
Delaware	NR	NR	NR
District of Columbia	No
Florida	No
Georgia	NR	NR	NR
Hawaii	Yes	No	No
Idaho	No
Illinois	Yes	No	NR
Indiana	No
Iowa	Yes	No	No
Kansas	No
Kentucky	Yes	No	NR
Louisiana	No
Maine	No
Maryland	Yes	No	Yes - not specified
Massachusetts	No
Michigan	Yes	No	Must comply with coding frequency for CPT codes 99492, 99493 and 99494, and for Federally Qualified Health Centers G0512
Minnesota	NR	NR	NR
Mississippi	No
Missouri	No
Montana	Yes	No	No
Nebraska	Yes	No	No
Nevada	No
New Hampshire	NR	NR	NR
New Jersey	Yes	No	No
New Mexico	No
New York	Yes	No	No
North Carolina	Yes	No	No
North Dakota	No
Ohio	No
Oklahoma	No
Oregon	Yes	No	No
Pennsylvania	Yes	No	No
Rhode Island	No
South Carolina	No
South Dakota	No
Tennessee	Yes	No	No
Texas	Yes	No	Prior authorization is required for an additional 6 calendar months (beyond the first 6 calendar months) of services
Utah	NR	NR	NR
Vermont	Yes	No	No
Virginia	No
Washington	Yes	No	No
West Virginia	No
Wisconsin	Yes	No	Continuous care cannot exceed 12 months in duration
Wyoming	No

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