Issued: February 4, 2020

AlphaMCS 2.15 Build

The next AlphaMCS build is scheduled to occur this Wednesday, February 5, 2020. The system will be unavailable from 5 p.m.p.mPlease make sure you are logged out of the AlphaMCS system prior to 5 p.m. 

If you have questions, please contact Partners’ IT Service Desk at 704-842-6431. 

Assertive Community Treatment Team Service Authorization Request Changes

Effective Feb. 1, 2020, a Person-Centered Plan (PCP) must be completed within 15 days of the initial authorization date per Clinical Coverage Policy 8A-1 for both Medicaid and State-funded Assertive Community Treatment Team (ACTT) services. Therefore, ACTT providers may now request an initial 30-day Service Authorization Request (SAR) in AlphaMCS without having to complete and attach the full PCP. A Comprehensive Clinical Assessment (CCA) and Service Order will need to be submitted with the initial service authorization request. The full PCP will be required at the first concurrent authorization.

The following changes to the Medicaid Adult Mental Health/Substance Use Benefit Grid have been made for ACTT services. 

Service Description 

Benefit Limit 

Level of Care 

Source 

Documentation Requirements 

Assertive Community Treatment 

Team: 

 

H0040 (DJ) 

Initial:  Four units for 30 days. 

 

First Concurrent: 24 units per six months. If member enters treatment with less than 14 days left in calendar month, authorize four units for partial month + 24 units per six months. 

 

Second Concurrent: 24 units per six months 

 

LOCUS: 3-5 

ASAM:  1-2.5 

8A-1  Initial:  CCA and Service Order. Service Orders are valid for one year. Full PCP required by First Concurrent authorization.  

 

First Concurrent: PCP anCCP 

 

Second Concurrent: Updated PCP. 

 

The following changes to the State Adult Mental Health/Substance Use Benefit Grid have been made for ACTT services: 

Service Description 

Benefit Limit 

Level of Care 

Source 

Documentation Requirements 

Assertive Community Treatment Team: 

 

H0040 

Initial: Four units for 30 days. 

 

First Concurrent: 16 units per four months. If member enters treatment with less than 14 days left in calendar month, authorize four units for partial month + 16 units per four months. 

 

Second Concurrent: 16 units per four months. 

 

LOCUS: 3-5 

ASAM:  1-2.5 

8A-1  Initial:  CCA and Service order. Service Orders are valid for one year. Full PCP required by First Concurrent authorization.  

 

First Concurrent: PCP and CCP.  

 

Second Concurrent: Documentation 

that application has been made for Medicaid. Updated PCP. 

If you have additional questions, please contact the Mental Health/Substance Use (MHSU) Utilization Management Workgroup at 704-842-6436. 

NC Medicaid Update:  Provider Application Process for Tailored Care Management—Extended Deadlines

The following information was published by NCTracks on behalf of NC Medicaid on Feb. 3, 2020:

The NC Department of Health and Human Services received many thoughtful comments on the Draft Provider Manual released Dec. 11, 2019. To ensure that the Department gives providers enough time to prepare their applications after the release of the finalized manual, the Department has decided to further extend the initial application deadline for providers from Feb. 21, 2020 to June 2020 (date to be determined).

The finalized manual and application form with be forthcoming. For more information about Tailored Care Management, visit the Behavioral Health I/DD Tailored Plan webpage.