What is the expectation for the Behavioral Health Provider to provide services while waiting for official CMDP eligibility when CPS places a child in an out- of-home placement situation?
All children referred from CPS are required to be seen through the 72-hour response process. If the child is T19 eligible, T19 funds are to be used, if not, crisis funding can be used or CMHS or SAPT funding as applicable. If the child becomes T19-enrolled after the placement, the RBHA is responsible for the prior period coverage if the placement is medically necessary and meets the Prior Authorization criteria. If the child does not become T19-enrolled, residential services are not a covered benefit. For instructions on providing services after the 72-hour response, please see this flow chart.
Related Questions
- I am waiting to take my national certification exam. Can I provide services under my supervisor, company, and/or facility provider approval number?
- Does this provider supply literature explaining its services, eligibility requirements, fees, and funding sources?
- Why should a provider verify Medicaid eligibility on a recipient prior to rendering services?
