Additional Guidance – Service Authorization Request Flexibilities

This communication provides additional guidance on submission of service authorization request (SAR) flexibilities using CR and GT CR modifiers as well as revised tables that supersede all tables from:

Requesting Services

Providers may request up to five service codes on each SAR. This will give the provider the ability to use different service code modifiers based on what is needed for the member. The units requested for COVID-19 codes (CR, GT CR) can mimic the base code requested. Please note proper uses of the CR and GT CR modifiers:

  • GT CR modifiers should be used for two-way audio and visual, telehealth service.
  • CR or FL modifiers should be used for additional COVID-19 flexibilities, including telephonic services and Appendix K unmanaged codes with CR or FL available.

The Treatment Plan/Service Plan does not have to be updated for use of the modifier codes during the COVID-19 crisis period. If an In Lieu of Service is being used for COVID-19, that service should be reflected on the member’s Treatment/Service Plan. All note documentation should reflect the reason for use of the COVID-19 flexibilities. Authorization of service is not a guarantee of payment.

When a modifier code is available, providers must use those codes to denote use of flexibilities when requesting authorization. Base codes will be reviewed for medical necessity. All clinical documentation should be submitted with the request of a base code.

If a modifier code is not available and a flexibility has been granted, providers must document the flexibility and reason in the member’s note documentation. If you have additional questions regarding SAR submissions, please contact:

  • MH/SU Utilization Management Workgroup: 704-842-6436
  • MH/SU Inpatient/Acute Services Utilization Management Workgroup: 704-842-6434
  • I/DD Utilization Management Workgroup: 704-884-2605

The service charts below denote when an authorization is needed
based on the COVID-19 flexibilities.

NO PRIOR AUTHORIZATION REQUIRED

MEDICAID SERVICE CODES SERVICE DESCRIPTION
90785 CR; 90785 GT CR Interactive Complexity
90791 CR; 90791 GT CR; 90791 GT IN; 90791 TI CR; 90791 TI GT CR Psychiatric Diagnostic Evaluation (No Med Services)
90792 CR; 90792 GT CR Psychiatric Diagnostic Evaluation with Medical Services
90832 CR; 90832 GT CR; 90832 GT IN Psychotherapy 30 Minutes
90833 CR; 90833 GT CR Psychotherapy 30 Minute Add on to E&M
90834 CR; 90834 GT CR Psychotherapy 45 Minutes
90836 CR; 90836 GT CR Psychotherapy 45 Minute Add on to E&M
90837 CR; 90837 GT CR Psychotherapy 60 Minutes
90838 CR; 90838 GT CR Psychotherapy 60 Minutes Addon to E&M
90839 CR; 90839 GT CR Psychotherapy for Crisis (30 to 74 Min)
90840 CR; 90840 GT CR Psychotherapy for Crisis Beyond 74 min.
90846 CR; 90846 GT CR Family Therapy without Patient
90847 CR; 90847 GT CR Family Therapy with Patient
90849 CR; 90849 GT CR Multi Family Group
90853 CR; 90853 GT CR Non-Family Multi Group Therapy
96110 CR; 96110 GT CR Devel Test Limit
96112 CR; 96112 GT CR Devel Test Admin & Score
96113 CR; 96113 GT CR Devel Adm & SC Add 30
96116 CR; 96116 GT CR Neurobehavioral Exam
96121 CR; 96121 GT CR Neurobehavioral Exam Add 1 Hr.
96130 CR; 96130 GT CR Psychological Evaluation and Interpretation
96131 CR; 96131 GT CR Psychological Evaluation and Interpretation ADD 1 Hr.
96132 CR; 96132 GT CR Neuropsychological Eval & Interpretation
96133 CR; 96133 GT CR Neuropsychological Eval & Interpretation Add 1 Hr. Add 1 Hr.
96136 CR; 96136 GT CR Psychological Scoring Physician
96137 CR; 96137 GT CR Psychol SC Physician Add 30
96138 CR; 96138 GT CR Psychological Scoring Technician
96139 CR; 96139 GT CR Psychological Scoring Technician Add 30
96146 CR; 96146 GT CR Psych or Neuro Test Administered by Electronic Platform
98966 CR Telephone assessment and management service provided by a qualified nonphysician health care professional to an established patient, parent or guardian not originating from a related assessment and management service
98967 CR Telephone assessment and management service provided by a qualified nonphysician health care professional to an established patient, parent or guardian not originating from a related assessment and management service
98968 CR; 98968 CR IN Telephone assessment and management service provided by a qualified nonphysician health care professional to an established patient, parent or guardian not originating from a related assessment and management service
99201 CR; 99201 GT CR Office or outpatient, E&M, new patient, problem focused, 10 min
99202 CR; 99202 GT CR Office or outpatient, E&M, new patient, expanded problem, 20 min
99203 CR; 99203 GT CR Office or outpatient, E&M, new patient, detailed exam, low complexity, 30 min
99204 CR; 99204 GT CR; 99204 GT IN Office or outpatient, E&M, new patient, comprehensive exam, moderate complexity, 45 min
99205 CR; 99205 GT CR Office or outpatient, E&M, new patient, comprehensive exam, high complexity, 60 min
99211 CR; 99211 GT CR Office or outpatient, E&M, established patient, may not require physician or other qualified health care professional, minimal problem(s), 5 min
99212 CR; 99212 GT CR Office or outpatient, E&M, established patient, problem focused, 10 min
99213 CR; 99213 GT CR Office or outpatient, E&M, established patient, expanded problem, low complexity, 15 min
99214 CR; 99214 GT CR; 99214 GT IN Office or outpatient, E&M, established patient, detailed exam, moderate complexity, 25 min
99215 CR; 99215 GT CR Office or outpatient, E&M, established patient, comprehensive exam, high complexity, 40 min
99231 CR; 99231 GT CR Subsequent Hospital 15 Min
99232 CR; 99232 GT CR Subsequent Hospital 25 Min
99233 CR; 99233 GT CR Subsequent Hospital 35 Min
99238 CR; 99238 GT CR Hospital Discharge 30
99239 CR; 99239 GT CR Hospital Discharge > 30 Min
99241 CR; 99241 GT CR Office consult, new or established patient, problem focused, 15 min
99242 CR; 99242 GT CR Office consult, new or established patient, expanded problem, 30 min
99243 CR; 99243 GT CR Office consult, new or established patient, expanded problem, 30 min
99244 CR; 99244 GT CR Office consult, new or established patient, comprehensive exam, moderate complexity, 60 min
99245 CR; 99245 GT CR Office consult, new or established patient, comprehensive exam, high complexity, 80 min
99251 GT CR Initial Inpt. Consult Phys. Time Approx. 20 Min.
99252 GT CR Initial Inpt. Consult
99253 GT CR Initial Inpt. Consult Phys. Time Approx. 55 Min.
99254 GT CR Initial Inpt. Consult Phys. Time Approx. 80 Min.
99255 GT CR Initial Inpt. Consult Phys. Time Approx. 80 Min.
99284 CR ER Visit, High Severity
99285 CR Emergency department visit for the evaluation and management of a patient
99421 CR; 99421 GT CR Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5 to 10 minutes
99422 CR; 99422 GT CR Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 11 to 20 minutes
99423 CR; 99423 GT CR Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes
99441 CR Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management (E/M) services provided to an established patient, parent or guardian not originating from a related E/M service
99442 CR Telephone evaluation and management service by a physician or other qualified health care professional who may report E/M services provided to an established patient, parent or guardian not originating from a related E/M service
99443 CR Telephone evaluation and management service by a physician or other qualified health care professional who may report E/M services provided to an established patient, parent or guardian not originating from a related E/M service
99446 CR; 99446 GT CR Interprofessional telephone/internet/electronic health records assessment and management service provided by a consultative physician, including a verbal and written report to the patient’s treating/requesting physician or other qualified
99447 CR; 99447 GT CR Interprofessional telephone/internet/electronic health records assessment and management service provided by a consultative physician, including a verbal and written report to the patient’s treating/requesting physician or other qualified
99448 CR; 99448 GT CR Interprofessional telephone/internet/electronic health records assessment and management service provided by a consultative physician, including a verbal and written report to the patient’s treating/requesting physician or other qualified
99449 CR; 99449 GT CR Interprofessional telephone/internet/electronic health records assessment and management service provided by a consultative physician, including a verbal and written report to the patient’s treating/requesting physician or other qualified
H0010 CR Non-Hospital Medical Detoxification
H0012 HB CR Substance Abuse Non-Medical Community Residential Treatment
H0013 CR SA Medically Monitored Community Residential Tx
H0014 CR Ambulatory Detox
H0015 CR; H0015 GT CR; H0015 AD CR; H0015 AD GT CR Substance Abuse Intensive Outpatient
H0020 CR Opioid Treatment
H0020 U3 OU CR Outpatient Opioid Treatment
H0035 U5; H0035 U5 GT Virtual Psychiatric Intensive Outpatient Treatment (Partial Hospitalization ILO for Disaster Definition)
H0038 CR; H0038 GT CR; H0038 EN CR; H0038 EN GT CR; H0038 DJ CR; H0038 DJ GT CR; H0038 HQ DJ CR; H0038 HQ DJ GT CR; H0038 CR IN; H0038 HQ CR; H0038 HQ GT CR Peer Support Services
H2011 CR; H2011 GT CR Mobile Crisis
H2015 HT HM CR; H2015 HT U1 CR; H2015 HT HN CR; H2015 HT HF CR; H2015 HT HO CR; H2015 HT HO DJ CR; H2015 HT HM GT CR; H2015 HT U1 GT CR; H2015 HT HN GT CR; H2015 HT HF GT CR; H2015 HT HO GT CR; H2015 HT U1 DJ CR; H2015 HT HF DJ CR; H2015 HT HM DJ CR; H2015 HT HN DJ CR; H2015 HT CR Community Support Team
H2017 CR; H2017 GT CR; H2017 DJ CR; H2017 DJ GT CR Psychosocial Rehabilitation
H2017 U5 Individual Rehabilitation, Coordination and Support Services
(PSR ILO Disaster Definition)
H2023 HQ U4 CR; H2023 HQ U4 GT CR; H2023 U4 CR; H2023 U4 HE DJ B3 Supported Employment (MHSU Only)
H2033 CR; H2033 GT CR; H2033 M1 CR; H2033 M1 GT CR; H2033 M2 CR; H2033 M2 GT CR; H2033 M3 CR; H2033 M3 GT CR; H2033 M4 CR; H2033 M4 GT CR; H2033 M5 CR; H2033 M5 GT CR Multi Systemic Therapy
H2035 CR; H2035 GT CR; H2035 CV SA Comprehensive Outpatient Txt Program
H2035 U5 SUD- Comprehensive Outpatient during Disaster (SACOT ILO Disaster Definition)
H2036 CR Medically Supervised or ADATC Detox Stabilization
T1023 CR; T1023 GT CR Diagnostic Assessment
H2015 CR; H2015 GT CR Community Networking
H2015 HQ CR; H2015 HQ GT CR Community Networking-Group
H2016 FL Residential Supports: Level 1
H2016 HI U2 FL Residential Supports: Level 4 AFL
H2016 HI FL Residential Supports: Level 4
H2016 U2 FL Residential Supports: Level 1 AFL
H2025 GT CR; H2025 CR Supported Employment Individual (I/DD)
H2025 HQ GT CR; H2025 HQ CR Supported Employment Group (I/DD)
H2025 TS CR; H2025 TS GT CR Supported Employment Long Term Follow-up Individual (I/DD)
H2025 TS HQ CR; H2025 TS HQ GT CR Supported Employment Long Term Follow-up Group (I/DD)
S5110 GT CR Natural Supports Education: Individual
T2013 CR; T2013 TF GT CR Community Living & Supports Individual
T2013 TF HQ CR; T2013 TF HQ GT CR Community Living & Supports Group
T2014 FL Residential Supports: Level 2
T2014 U2 FL Residential Supports: Level 2 AFL
T2020 FL Residential Supports: Level 3
T2020 U2 FL Residential Supports: Level 3 AFL
T2021 CR; T2021 GT CR Day Supports Individual
T2021 HQ CR;
T2021 HQ GT CR
Day Supports Group
T2025 GT CR Specialized Consultation Services
T2027 GT CR Day Supports Developmental Day
T2033 FL; T2033 GT CR Supported Living 1
T2033 HI FL;
T2033 HI GT CR
Supported Living 2
T2033 TF FL;
T2033 TF GT CR
Supported Living 3
T2033 U1 FL Supported Living Periodic
T2041 GT CR Community Navigator Monthly
STATE SERVICE CODES SERVICE DESCRIPTION
90785CR; 90785 GT CR Interactive Complexity
90791 CR; 90791 GT CR Psychiatric Diagnostic Evaluation (No Med Services)
90792 CR; 90792 GT CR Psychiatric Diagnostic Evaluation with Medical Services
90832 CR; 90832 GT CR Psychotherapy 30 Minutes
90833 CR; 90833 GT CR Psychotherapy 30 Minute Add on to E&M
90834 CR; 90834 GT CR Psychotherapy 45 Minutes
90836 CR; 90836 GT CR Psychotherapy 45 Minutes Add on to E&M
90837 CR; 90837 GT CR Psychotherapy 60 Minutes
90838 CR; 90838 GT CR Psychotherapy 60 Minutes Addon to E&M
90839 CR; 90839 GT CR Psychotherapy for Crisis (30 to 74 Min)
90840 CR; 90840 GT CR Psychotherapy for Crisis Beyond 74 min.
90846 CR; 90846 GT CR Family Therapy without Patient
90847 CR; 90847 GT CR Family Therapy with Patient
90849 CR; 90849 GT CR Multi Family Group
90853 CR; 90853 GT CR Non-Family Multi Group Therapy
96110 CR; 96110 GT CR Devel Tst Lmt
96112 CR; 96112 GT CR Devel Test Admin & Score
96113 CR; 96113 GT CR Devel Adm & SC Add 30
96116 CR; 96116 GT CR Neurobehavioral Exam
96121 CR; 96121 GT CR Neurobehavioral Exam Add 1 Hr.
96130 CR; 96130 GT CR Psychological Evaluation and Interpretation
96131 CR; 96131 GT CR Psychological Evaluation and Interpretation ADD 1 Hr.
96132 CR; 96132 GT CR Neuropsychological Eval & Interpretation
96133 CR; 96133 GT CR Neuropsychological Eval & Interpretation Add 1 Interpretation Add 1 Hr.
96136 CR; 96136 GT CR Psychological Scoring Physician
96137 CR; 96137 GT CR Psychological SC Physician Add 30
96138 CR; 96138 GT CR Psychological Scoring Technician
96139 CR; 96139 GT CR Psychological Scoring Technician Add 30
96146 CR; 96146 GT CR Psych or Neuro Test Administered by Electronic Platform
98966 CR Telephone assessment and management service provided by a qualified nonphysician health care professional to an established patient, parent or guardian not originating from a related assessment and management service provided
98967 CR Telephone assessment and management service provided by a qualified nonphysician health care professional to an established patient, parent or guardian not originating from a related assessment and management service provided
98968 CR Telephone assessment and management service provided by a qualified nonphysician health care professional to an established patient, parent or guardian not originating from a related assessment and management service provided
99201 CR; 99201 GT CR Office or outpatient, E&M, new patient, problem focused, 10 min
99202 CR; 99202 GT CR Office or outpatient, E&M, new patient, expanded problem, 20 min
99203 CR; 99203 GT CR Office or outpatient, E&M, new patient, detailed exam, low complexity, 30 min
99204 CR; 99204 GT CR  Office or outpatient, E&M, new patient, comprehensive exam, moderate complexity, 45 min
99205 CR; 99205 GT CR Office or outpatient, E&M, new patient, comprehensive exam, high complexity, 60 min
99211 CR; 99211 GT CR Office or outpatient, E&M, established patient, may not require physician or other qualified health care professional, minimal problem(s), 5 min
99212 CR; 99212 GT CR Office or outpatient, E&M, established patient, problem focused, 10 min
99213 CR; 99213 GT CR Office or outpatient, E&M, established patient, expanded problem, low complexity, 15 min
99214 CR; 99214 GT CR Office or outpatient, E&M, established patient, detailed exam, moderate complexity, 25 min
99215 CR; 99215 GTCR Office or outpatient, E&M, established patient, comprehensive exam, high complexity, 40 min
99231 CR; 99231 GT CR Subsequent Hospital 15 Min
99232 CR; 99232 GT CR Subsequent Hospital 25 Min
99233 CR; 99233 GT CR Subsequent Hospital 35 Min
99238 CR; 99238 GT CR Hospital Discharge 30
99239 CR; 99239 GT CR Hospital Discharge > 30 Min
99241 CR; 99241 GT CR Office consult, new or established patient, problem focused, 15 min
99242 CR; 99242 GT CR Office consult, new or established patient, expanded problem, 30 min
99243 CR; 99243 GT CR Office consult, new or established patient, expanded problem, 30 min
99244 CR; 99244 GT CR Office consult, new or established patient, comprehensive exam, moderate complexity, 60 min
99245 CR; 99245 GT CR Office consult, new or established patient, comprehensive exam, high complexity, 80 min
99251 GT CR Initial Inpt. Consult Phys. Time Approx. 20 Min.
99252 GT CR Initial Inpt. Consult
99253 GT CR Initial Inpt. Consult Phys. Time Approx. 55 Min.
99254 GT CR Initial Inpt. Consult Phys. Time Approx. 80 Min.
99255 GT CR Initial Inpt. Consult Phys. Time Approx. 80 Min.
99284 CR ER visit, High Severity
99285 CR Emergency department visit for the evaluation and management of a patient
99421 CR; 99421 GT CR Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5 to 10 minutes
99422 CR; 99422 GT CR Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 11 to 20 minutes
99423 CR; 99423 GT CR Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes
99441 CR Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management (E/M) services provided to an established patient, parent or guardian not originating from a related E/M service
99442 CR Telephone evaluation and management service by a physician or other qualified health care professional who may report E/M services provided to an established patient, parent or guardian not originating from a related E/M service
99443 CR Telephone evaluation and management service by a physician or other qualified health care professional who may report E/M services provided to an established patient, parent or guardian not originating from a related E/M service
99446 CR; 99446 GT CR Interprofessional telephone/internet/electronic health records assessment and management service provided by a consultative physician, including a verbal and written report to the patient’s treating/requesting physician or other qualified
99447 CR; 99447 GT CR Interprofessional telephone/internet/electronic health records assessment and management service provided by a consultative physician, including a verbal and written report to the patient’s treating/requesting physician or other qualified
99448 CR; 99448 GT CR Interprofessional telephone/internet/electronic health records assessment and management service provided by a consultative physician, including a verbal and written report to the patient’s treating/requesting physician or other qualified
99449 CR; 99449 GT CR Interprofessional telephone/internet/electronic health records assessment and management service provided by a consultative physician, including a verbal and written report to the patient’s treating/requesting physician or other qualified
H0020 CR Opioid Treatment
H2011 CR; H2011 GT CR Mobile Crisis
H2033 CR; H2033 GT CR; H2033 M1 CR; H2033 M1 GT CR; H2033 M2 CR; H2033 M2 GT CR; H2033 M3 CR; H2033 M3 GT CR; H2033 M4 CR; H2033 M4 GT CR; H2033 M5 CR; H2033 M5 GT CR Multi Systemic Therapy
T1023 CR; T1023 GT CR Diagnostic Assessment

INITIAL Requests Only: Medical Necessity Review Required (Clinical Documentation Required to be Submitted with SAR)– REVISED

MEDICAID SERVICE CODES SERVICE DESCRIPTION
90837 U5 Outpatient Plus
97151 CR; 97151 GT CR; 97151 NC CR; 97151 NC GT CR RBBHT Comprehensive Clinical Assessment
97152 CR; 97152 GT CR; 97152 NC CR RBBHT Assess Follow Up
97153 CR; 97153 GT CR RBBHT ABA
97154 CR; 97154 GT CR RBBHT ABA >2
97155 CR; 97155 GT CR RBBHT Supervision, Parent Training
97156 CR; 97156 GT CR RBBHT Parent Training Without Child
97157 CR; 97157 GT CR RBBHT Parent Training Group
H0032 HF High Fidelity Wrap Around
H0035 CR; H0035 GT CR Mental Health Partial Hospitalization
H0040 CR; H0040 GT CR; H0040 DJ GT CR; H0040 DJ CR Assertive Community Treatment Team
H2012 HA CR; H2012 HA GT CR; H2012 HA CV Child Adolescent Day Treatment
H2020 CR; S5145; S5145 HA Level II Program Type
H2022 CR; H2022 GT CR Intensive In-Home
H2022 U5 Young Adults in Transition
H2023 U4 GT CR; H2026U4 GT CR; H2026HQU4 GT CR (B3) Supported Employment IDD (Individual, Individual Maintenance, Group Maintenance)
S9484 CR: S9484 HA CR CRISIS INTERVENTION (FACILITY BASED)
T1019U4CR; T1019U4GTCR (B3) MH/SU Individual Support
T2013 U4 CR; T2013 U4 GT CR (B3) In-Home Skill Building Individual
T2041U4U5 GT CR (B3) Community Guide
STATE SERVICE CODES SERVICE DESCRIPTION
90791 TI CR; 90791 TI GTCR Psychiatric Diagnostic Evaluation (No Med Services)
YA389 GT CR Long-Term Vocational Support Services (Extended Services-IDD)
YA390 GT CR Supported Employment-IDD Individual
YM580 GT CR Day Supports
YP020 GT CR Personal Assistance Ind.
YP610 GT CR Developmental Day
YP620 GT CR Adult Developmental Vocational Program (ADVP)
YP640 GT CR Supported Employment-IDD Group
YP660 GT CR Day/Evening Activity

Concurrent/Reauthorization Only – Notification SAR (SAR Only, No Clinical Documentation Required to be Submitted with SAR) – REVISED

MEDICAID SERVICE CODES SERVICE DESCRIPTION
90837 U5 Outpatient Plus
97151 CR; 97151 GT CR; 97151 NC CR; 97151 NC GT CR RBBHT Comprehensive Clinical Assessment
97152 CR; 97152 GT CR; 97152 NC CR RBBHT Assess Follow Up
97153 CR; 97153 GT CR RBBHT ABA
97154 CR; 97154 GT CR RBBHT ABA >2
97155 CR; 97155 GT CR RBBHT Supervision, Parent Training
97156 CR; 97156 GT CR RBBHT Parent Training Without Child
97157 CR; 97157 GT CR RBBHT Parent Training Group
H0032 HF High Fidelity Wrap Around
H0035 CR; H0035 GT CR Mental Health Partial Hospitalization
H0040 CR; H0040 GT CR; H0040 DJ GT CR; H0040 DJ CR Assertive Community Treatment Team
H2012 HA CR; H2012 HA GT CR; H2012 HA CV Child Adolescent Day Treatment
H2020 CR; S5145; S5145 HA Level II Program Type
H2022 CR; H2022 GT CR Intensive In-Home
H2022 U5 Young Adults in Transition
H2023 U4 GT CR; H2026U4 GT CR; H2026HQU4 GT CR (B3) Supported Employment IDD (Individual, Individual Maintenance, Group Maintenance)
S9484 CR: S9484 HA CR Crisis Intervention (Facility Based)
T1019U4CR; T1019U4GTCR (B3) MH/SU Individual Support
T2013 U4 CR; T2013 U4 GT CR (B3) In-Home Skill Building – Individual
T2041U4U5 GT CR (B3) Community Guide
STATE SERVICE CODES SERVICE DESCRIPTION
YA389 GT CR Long-Term Vocational Support Services (Extended Services-IDD)
YA390 GT CR Supported Employment-IDD Individual
YM580 GT CR Day Supports
YP020 GT CR Personal Assistance Ind.
YP610 GT CR Developmental Day
YP620 GT CR Adult Developmental Vocational Program (ADVP)
YP640 GT CR Supported Employment-IDD Group
YP660 GT CR Day/Evening Activity

Initial and Concurrent/Reauthorization Medical Necessity Review Required (Clinical Documentation Required to be Submitted with SAR)

MEDICAID SERVICE CODES SERVICE DESCRIPTION
S9484 CR: S9484 HA CR CRISIS INTERVENTION (FACILITY BASED)

 

STATE SERVICE CODES SERVICE DESCRIPTION
H0010 CR Non-Hospital Medical Detoxification
H0012 HB CR Substance Abuse Non-Medical Community Residential Treatment
H0013 CR SA Medically Monitored Community Residential Tx
H0014 CR Ambulatory Detox
H0015 CR; H0015 GT CR Substance Abuse Intensive Outpatient
H0038 CR; H0038 EN CR; H0038 GT CR; H0038 DJ CR; H0038 HQ CR; H0038 HQ GT CR Peer Support Services
H0040 CR; H0040 GT CR Assertive Community Treatment Team
H2015 HT HM GT; H2015 HT U1 GT; H2015 HT HN GT; H2015 HT HF GT; H2015 HT HO GT; H2015 HT GT; H2015 HT CR; H2015 HT HM CR; H2015 HT U1 CR; H2015 HT U1 DJ CR;  H2015 HT HN CR; H2015 HT HF CR; H2015 HT HF DJ CR; H2015 HT HO CR; H2015 HT HO DJ CR; H2015 HT HM DJ CR; H2015 HT HN DJ CR Community Support Team
H2017 CR; H2017 GT CR Psychosocial Rehabilitation
H2035 CR; H2035 GT CR; H2035 CV SA Comprehensive Outpatient Txt Program
S9484 CR Crisis Intervention (Facility Based)
YP400 GT CR; YP400 CR Critical Time Intervention

Innovations Guidance Effective July 1, 2020:  Appendix K Waiver Flexibilities – CR and FL modifier codes: The CR or FL modifier codes will be used when the provider is billing for services above the approved ISP using Appendix K flexibilities, as indicated in the chart below. Please note, for the FL codes listed, the base code and the FL code may not be billed on the same day, as subsequent claims for these codes will deny for non-compatibility.

The CR and FL modifier codes are unmanaged (no SAR/authorization is required).

Reminder: If the member needs to use Appendix K flexibilities, submit the Appendix K Reporting form by email to both the assigned Care Manager and innovationsexceptions@partnersbhm.org. The provider will follow the Appendix K reporting process and bill using the CR and FL modifier codes.

H2015 CR Community Networking Individual
H2015 HQ CR Community Networking Group
H2016 FL Residential Supports: Level 1
H2016 HI U2 FL Residential Supports: Level 4 AFL
H2016 HI FL Residential Supports: Level 4
H2016 U2 FL Residential Supports: Level 1 AFL
H2025 CR Supported Employment Individual
H2025 HQ CR Supported Employment Group
H2025 TS CR Supported Employment LTFU Individual
H2025 TS HQ CR Supported Employment LTFU -Group
S5150 FL Respite Individual
S5150 HQ FL Respite Group
S5150 US FL Respite Facility
T1005 TD FL Nursing Respite RN
T1005 TE FL Nursing Respite LPN
T2013 TF CR Community Living & Supports
T2013 TF HQ CR Community Living & Supports Group
T2014 FL Residential Supports: Level 2
T2014 U2 FL Residential Supports: Level 2 AFL
T2020 FL Residential Supports: Level 3
T2020 U2 FL Residential Supports: Level 3 AFL
T2021 CR Day Supports Individual
T2021 HQ CR Day Supports Group
T2027 CR Day Supports Developmental Day
T2033 FL Supported Living 1
T2033 HI FL Supported Living 2
T2033 TF FL Supported Living 3
T2033 U1 FL Supported Living Periodic

Partial Hospitalization Program Guidance

Partial Hospitalization (PHP) is a valuable and effective intervention, especially in the prevention of inpatient treatment for Partners’ members. In accordance with NCDHHS Clinical Coverage Policy 8A, Partial Hospitalization (PHP) is  short-term service for acutely mentally ill children or adults, which provides a broad range of intensive therapeutic approaches which may include: group activities or therapy, individual therapy, recreational therapy, community living skills or training, increases the individual’s ability to relate to others and to function appropriately, coping skills, medical services. This service is designed to prevent hospitalization or to serve as an interim step for those leaving an inpatient facility.  A physician shall participate in diagnosis, treatment planning, and admission or discharge decisions.

UM asks providers to consider CCP 8A in providing and making referrals to Partial Hospitalization. Although “CR” modifier exceptions remain in place, Partners Utilization Management supports active discharge planning in assisting members transitioning from this service.

Partners Provider Portal Training

As noted in previous Provider Council meetings, Partners will go live with its new Provider Portal in 2021. Over time, the provider portal will become the primary resource for operational information when working with Partners. Providers will access the portal for day-to-day operations such as authorizations, billing, claims and clinical care, as well as notifications.

The first step in connecting providers to the Provider Portal is to establish accounts for all provider organizations. Each provider organization will need to identify local portal administrators and the staff who will use the portal. The local portal administrator and staff will also need to register and attend a training session. Multiple training sessions will be facilitated via Zoom Nov. 9-Nov. 20; dates, times and registration links are listed in the Partners Training for Members, Providers and the Community section of this bulletin.

For a period of time, information currently posted on the Provider Knowledge Base website will be available both outside and inside the provider portal. Eventually, all information currently displayed in the Provider Knowledge Base, including bulletins and alerts, will move to the portal. In the future, Partners will introduce new portal features in phases and offer training in advance of the launch of the feature.

If you have questions about the upcoming Provider Portal training, please contact training@partnersbhm.org.

Electronic Visit Verification for Personal Care Services

Partners has communicated individually with the providers impacted regarding the information below. 

The Twenty First Century Cures Act (Cures Act) mandates that all Personal Care Service visits and Home Health Care Service visits must be timestamped via an electronic verification method utilizing Electronic Visit Verification system (EVV) tools to record the member, caregiver, location of the service, date of the service and the type of service performed. Section 12006 of the Cures Act and The Centers for Medicare & Medicaid Services (CMS) will require states to begin utilizing an EVV for all Personal Care Services by January 1, 2021 and all Home Health Care Services by January 1, 2023.

Partners values our providers’ efforts to deliver quality care. To ensure we are fully compliant with the Cures Act and CMS, Partners will require all providers to implement electronic visit verification (EVV) for Personal Care Services by January 1, 2021. We have partnered with HHAeXchange to provide a free EVV and billing tool for member placement, scheduling, authorization management, communication and compliance for Home Health Aide services.

HHAX Platform Options

As a member of Partners’ provider network, you have multiple options available to you at no cost to ensure EVV compliance. All Partners’ providers must use the HHAeXchange platform through one of the two options listed below:

  • Agencies currently without an EVV Solution: You will be set up to use free EVV tools from HHAeXchange for homecare services.
  • Agencies currently using another third-party EVV Solution: You will use your existing EVV system and import visit data into HHAeXchange using Electronic Data Interchange (EDI).

HHAeXchange Portal Configuration Questionnaire

In order for HHAeXchange to configure your Provider Portal, we ask that you complete the HHAeXchange Portal Configuration Questionnaire no later than October 21, 2020. The questionnaire link can be found here: www.hhaexchange.com/LMEProviderSurvey.

Next Step – Attend an Information Session

Information sessions will be held jointly with the other LME/MCOs using HHAeXchange beginning in October. A link to the information session registration will be provided to the contact who completes the HHAeXchange Portal Configuration Questionnaire. Due to the COVID-19 pandemic, Partners and HHAeXchange will offer information sessions via webinar to ensure providers are able to comply with the CURES Act while protecting the health and safety of all employees.

Information sessions will be held:

  • Tuesday, October 27, 10 a.m.
  • Wednesday, October 28, 11 a.m.
  • Thursday, October 29, 2 p.m.

Please note: A link to the information session registration will be provided to the contact who completes the HHAeXchange Portal Configuration Questionnaire.

Services Impacted

Code

Description

Partners Benefit Plan

(b)(3) Services

T1019 U4 Personal Care/Individual Support T1019 U4 (b)(3) Individual Support (MH/SU)
H2022 U4 Transitional Living Skills H2022 U4 (b)(3) Transitional Living Skills (MH/SUD)
T2013 U4 In Home Skill Building T2013 U4 (b)(3) In-Home Skill Building (I/DD)
T2013 TF HQ U4 Community Living and Supports – Group N/A
T2013 TF U4 Community Living and Supports N/A
T2033 U1 Supported Living – Periodic N/A

Innovations Services

T2013 TF HQ Community Living and Supports – Group T2013 TF HQ Community Living & Supports – Group (I/DD)
T2013 TF Community Living and Supports T2013 TF Community Living & Supports – Individual (I/DD)
T2013 TF EO Community Living & Supports – Individual – Employer of Record (I/DD)
T2033 U1 Supported Living – Periodic Supported Living Periodic (I/DD)

Traumatic Brain Injury (TBI) services

S5125 Personal Care N/A
T1015 In Home Intensive N/A
T2013 Life Skills Training – Individual and Group N/A

If you have questions or need help, please contact your Partners’ provider specialist at pas@partnersbhm.org.

Requests for Services

Partners has issued two requests for services. Information about the request is available at https://providers.partnersbhm.org/request-for-services/.

Providers that are interested in learning more or submitting interest or a proposal for these services may review the criteria and instructions available at https://providers.partnersbhm.org/request-for-services/.

Emergency Solutions Grant Funds Available for Housing Assistance

The economic challenges and high unemployment due to COVID-19 have caused many individuals to become either housing insecure or to enter the homeless system for the first time. In order to address the housing crisis caused by the economic effects of the COVID-19 pandemic, the Department of Housing and Urban Development authorized funding through the CARES Act. These funds are being allocated through the NC Department of Health and Human Services Emergency Solutions Grant office, and the impact will be felt across the state. The funds will be used to help families experiencing homelessness and will work to stabilize the household until they can once again become self-sufficient. The funds will also provide financial assistance as a preventative measure for households that are facing evictions and need temporary assistance. Each of the nine counties in Partners’ catchment area will have this program available through rehousing agencies. To begin the referral process, members should call 211. Please contact Bre Griffin for more information at bgriffin@partnersbhm.org or 704-884-2514.

Claims Information

Explanation of Benefits Requests for Coordination of Benefits Claims: As a reminder, Partners does request copies of the Explanation of Benefits (EOB) for members/claims submitted indicating Coordination of Benefits. The request will originate via email from Partners’ Claims Department. Once requested, please submit the information, via secured email, prior to the date indicated in the emailed request. If a response is not received, the original claim payment will be recouped.

September 2020: Medicaid—Number of Days to Process and Pay All Claims

Received Date to Paid Date:

8.9

Top Five Medicaid Claim Denials for September 2020

Claim Denial

Provider Recommended Action Steps

Service is not authorized Verify Service Authorization for consumer. Contact Utilization Management.
Claim received after billing period. Write-off charges as non-billable. Do not rebill.
Duplicate Claim The claim has previously been submitted and adjudicated. Do not refile.
R&B Service already exists – cannot bill another one. Only one occurrence of service is billable per day. Adjust off charges and do not refile.
No coverage available for Patient/Service/Provider Combo Go to Patient -> Patient Search and search for the patient in question. Check the insurance to ensure the patient has effective insurance covering to date of service submitted on the claim. If this appears to be correct, contact the MCO for further assistance.

Appointment Scheduling

Providers offering appointments through the AlphaMCS Slot Scheduler need to ensure that appointments are scheduled correctly. Please make sure that your appointments account for the:

  • Correct operating hours over holidays and vacations.
  • Type of funding and clients served (Medicaid or state).

Providers should upload appointments for the next month at least two weeks prior to the beginning of the month. In addition, please inform Access to Care if you are adjusting hours due to operational changes.

If you have any questions, please contact Access to Care at 1-888-235-4673.

Upcoming Provider Meetings

Innovations and I/DD Provider Information Session: Partners will host a virtual Innovations and I/DD Provider Information Session on October 23 beginning at 1 p.m. Click here to register. You may submit your questions to questions@partnersbhm.org in advance; we also recommend that you review the FAQs from past information sessions.

Partners’ Provider Council: The Partners’ Provider Council is a group of professional representatives and advocates for all service providers in the Partners’ catchment area. The Council facilitates an open exchange of ideas and brings forward concerns and solutions while promoting collaboration and mutual accountability among providers. Meetings are being held virtually until further notice.

October Provider Council

Oct. 23, 2020, 9:30 a.m.

Click here to register

November Provider Council
(Date change due to the Thanksgiving holiday)

Nov. 19, 2020, 1 p.m.

Click here to register

Licensed Independent Practitioner Collaborative: The Licensed Independent Practitioner (LIP) collaborative was developed to improve communication between Partners and Licensed Independent Practitioners. Meetings are held quarterly via webinar. The LIP Collaborative will meet on November 18, 2020 from noon-1 p.m. Learn more

Partners Trainings for Members, Providers and the Community

All training sessions are free to registered attendees. Register in advance at www.PartnersTraining.org. If you have any questions, please email Training@PartnersBHM.org.

Member Education

Partners Member Café: The second Tuesday of each month, 1 p.m.-2 p.m. Click here to register

Partners is hosting monthly Member Cafes – virtual meetings for members to learn about resources, voice concerns and speak directly to Partners’ employees who can assist in navigating the publicly funded behavioral health service system.

Psychiatric Advance Directive (PAD) Training

Multiple sessions are available. Sessions are held:

In this training, hosted by Partners and NAMI South Mountains, members will be provided with the resources needed to create their own PAD so that treatment preferences, should they not be able to communicate for themselves, are shared with and heard by the treatment provider. A certified trainer will provide participants with the information and tools needed to create a PAD.

Training for Providers

Provider Portal Training

Multiple sessions available; click on date and time to register

This training will inform providers of key elements they need to know regarding the new Provider Portal. Providers should attend one of several training opportunities offered between November 9-20.

Training Dates and times:

November 9, 2020

November 12, 2020

November 13, 2020

November 16, 2020

November 17, 2020

November 18, 2020

November 19, 2020

November 20, 2020

Cultural Competency: CLAS Standards

Oct 20, 2020, 8:45 a.m. -11:30 a.m., Online (Register)

The Office of Minority Health has established Culturally and Linguistically Appropriate Services (CLAS) standards to address health equity and improve outcomes. This training will not only review the standards themselves but review the wealth of tools and training materials available free of charge to providers.

Target Audience: Providers who wish to enhance knowledge of CLAS standards and training resources

Trainers: Provider Network Trainers

Person Centered Planning Instructional Elements Additional Seats Added!   

Oct. 30, 2020, 8:30 a.m.-12:15 p.m. (Register)

This course will meet the requirement for three hours of training for PCP Instructional Elements. Training content will include documentation requirements for both Person Centered Plans (PCP’s) and Crisis Plans. All providers are invited, especially those that write PCP’s and Crisis Plans. Individual pre-registration required. Max of 40 participants.

Target Audience: Leaders and staff who write or audit Person Centered Plans

Facilitators: Partners Utilization Management Staff

Provider Open House

Nov. 5, 2020, 9 a.m. – 11 a.m., Online (Register)

Join Partners’ Provider Network, Claims, Access to Care, Utilization Management, Care Management and Quality Management staff for an interactive information session. This open-house style event will allow each attendee time to work one-on-one with Partners’ staff to discuss any issues, questions or unfamiliar topics.

For this session, we will be using Zoom and breakout rooms. These sessions will not have a formal presentation or start time but are the providers’ time to meet one-on-one with Partners’ staff for technical assistance. Providers will need to register prior to the event. As a registered attendee, you are welcome to arrive and exit at your convenience, depending on the amount of time you feel is needed with our staff. The intended audience for the open house includes established and new providers in Partners’ network. Providers who are new to Partners’ network are advised to have already established access to AlphaMCS and have reviewed the provider orientation toolkit prior to attending a session.

Target Audience: Existing and new providers in the Partners’ network.

Trauma-Informed Care: Seeking Safety

November 10, 2020, 9 a.m.-12:30 p.m. (Register)

Join Partners Training Academy as we host Trauma-Informed Care Cognitive Behavioral Therapy with Seeking Safety. Trauma plays a major role in why people get stuck and use problematic coping strategies. Understand trauma, PTSD and the treatment of substance use disorders better with Seeking Safety.

Training will take place over two days, November 10 and 12 from 9 a.m.-12:30 p.m., utilizing the same training link both days. Participants will have to be present with audio and visual capabilities for both sessions to receive credit. No Partial credit will be given.
Trainer: Eric Ottinger
NCSAPPB approved for up to six hours 19-558-S. NBCC approved for six hours
Partners has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 6932. Programs that do not qualify for NBCC credit are clearly identified. Partners is solely responsible for all aspects of the programs.

Community Support Team Service Definition

November 17, 2020, 12:30 p.m.-3:45 p.m. (Register)

This webinar meets the requirement for three hours of CST Service Definition training. Registrants will view a previously recorded training that includes two ten-minute breaks.  In order to receive a training certificate, registrants will need to view the full webinar and pass a ten question quiz with a score of 80% or higher.

Cognitive Behavioral Therapy (CBT) Learning Community

  • November 18, 2020, 2 p.m.-3 p.m. (Register)
  • December 16, 2020, 2 p.m.-3 p.m. (Register)

Join like-minded providers in a learning community to explore skills, concepts, case studies, and expand your own techniques. This learning community will help you learn practical ways to use evidence based practices in your day to day work with members.

Providing ASAM Informed Treatment

December 1, 2020, 8:30 a.m.-11:45 a.m. (Register)

This American Society of Addiction Medicine course meets service definition requirements for ASAM training. Participants will receive tools in the form of handouts and watch a pre-recorded webinar training. A certificate is offered once registrants pass a 10-question quiz. Course content includes the purpose of ASAM, an overview of ASAM changes and DSM5 changes, ASAM dimensions and level of care, clinical assessment and the application to treatment planning, level of care and risk assessments as well as informed treatment and medical necessity.

Target Audience: Providers who need initial training and/or a refresher.

Trainer: Partners’ Utilization Management Staff

Other Training Resources and Opportunities

ASAM Training Project (Online–live)

Please visit https://bhs.unc.edu/asam/dashboard for more information including continuing education credit options, training dates and registration. This is a skills-based training and is not the same general overview content as the ASAM training provided by the Partners Training Academy.

Events are scheduled throughout the year through June 2021.

Each course has limited registration. Fee: $90. Live training includes 13 contact hours, the time-limited use of an electronic version of The ASAM Criteria manual (third edition) and an opportunity to obtain a hard copy of the manual for $15.50.

Description: This training project is a part of the 1115 Substance Use Disorder Demonstration Waiver implementation plan. The plan includes 1) the use of The ASAM Criteria to determine the appropriate level of care required for beneficiaries and 2) ensuring direct enrolled professionals providing comprehensive clinical assessments (CCA), diagnostic assessments (DA) and other evaluations which have the knowledge, skills and ability to make an ASAM level of care determination for beneficiaries with a substance use disorder diagnosis.

Target Audience: Behavioral health clinicians in North Carolina who are contracted with an LME/MCO or provide CCA, DA and other evaluations (LCSW, LCSW-A, LCMHC, LCMHC-A, LCAS, LCAS-A, LMFT, LMFT-A, PA, NP, MD)

Trainer: Train for Change Inc, in collaboration with the UNC School of Social Work – Behavioral Health Springboard and NW AHEC

ASAM Training Project (Online–eTraining)

Please visit https://bhs.unc.edu/asam/dashboard for more information including continuing education credit options, training dates and registration. This is a skills-based training and is not the same general overview content as the ASAM training provided by the Partners Training Academy.

The fee is $75 and offers extended-access licenses for practitioners to access three modules of eTraining covering The ASAM Criteria. eTraining includes 12 contact hours and access to modules through June 30, 2021.

Description: This training project is a part of the 1115 Substance Use Disorder Demonstration Waiver implementation plan. The plan includes the use of The ASAM Criteria to determine the appropriate level of care required for beneficiaries and ensures direct enrolled professionals providing comprehensive clinical assessments (CCA), diagnostic assessments (DA) and other evaluations which have the knowledge, skills and ability to make an ASAM level of care determination for beneficiaries with a substance use disorder diagnosis.

Target Audience: Behavioral health clinicians in North Carolina who are contracted with an LME/MCO or provide CCA, DA and other evaluations (LCSW, LCSW-A, LCMHC, LCMHC-A, LCAS, LCAS-A, LMFT, LMFT-A, PA, NP, MD).

Trainer: Train for Change Inc, in collaboration with the UNC School of Social Work – Behavioral Health Springboard and NW AHEC

Resource for ACT and IPS Trainings

The Institute for Best Practices, UNC Chapel Hill, www.institutebestpractices.org.

  1. NC ACT Coalition Meeting (ACT coalition members only) is the third Tuesday of the month from 11:00 a.m.-12:30 p.m. (Register)
  2. The National ACT Meet Up for providers is the first Monday of the month (Nov. 2) from 3:00 p.m.-4:30 p.m. (Eastern Time). (Register)
  3. Tea with CST (CST providers only) is every other Wednesday from 1:00 p.m.-1:45 p.m. (Register)
  4. IPS Executive Leadership is the second Thursday of every month from 1:00 p.m.-2:30 p.m. (Register)
  5. IPS Team Lead is the third Thursday of every month from 1:00 m.-2:30 p.m. (Register)

Improving Cultural Competency for Behavioral Health Professionals (Online)

https://thinkculturalhealth.hhs.gov/education/behavioral-health

Date, Time, Location: This training is a self-study from the Office of Minority Health website: FREE CEUs.

Description: Cultural and linguistic competency is recognized as an important strategy for improving the quality of care provided to clients from diverse backgrounds. The goal of this e-learning program is to help behavioral health professionals increase their cultural and linguistic competency.

  • In Course 1, An introduction to cultural and linguistic competency, you’ll learn what culture has to do with behavioral health care.
  • In Course 2, Know thyself – Increasing self-awareness, you’ll learn how to get to know your cultural identity and how it affects your work with clients.
  • In Course 3, Knowing others – Increasing awareness of your client’s cultural identity, you’ll learn how to get to know your client’s cultural identity.
  • In Course 4, Culturally and linguistically appropriate interventions and services, you’ll learn how to build stronger therapeutic relationships with clients from diverse backgrounds.

The estimated time to complete all four courses is between 4-5.5 hours.

Target Audience: This program is accredited for 4-5.5 contact hours for counselors, nurses, psychologists, psychiatrists and social workers. Other professionals may earn a Statement of Participation.

Resources to Improve Business Acumen:

SCORE is a resource partner of the U.S. Small Business Association and has been in existence since 1964. (https://www.score.org/)

SCORE offers a variety of training courses for a low cost or for free. In addition to training, they offer volunteer counselors, advisors and mentors who offer individual, free to low-cost counseling throughout the US. They also have many free online courses on many topics related to running and growing your business. (https://www.score.org/courses-demand?page=2)

The Small Business Development Center offers local business consulting and at-cost training on a variety of business-related topics at https://americassbdc.org/small-business-consulting-and-training/find-your-sbdc/.

There are SBDCs in Charlotte, Hickory, Boone, Winston-Salem, Greenville, Asheville and many other locations across the state.

Community Events and Training

Aunt Bertha Virtual Community Event

Date and Time: October 20, 2020, 1 p.m.-2 p.m. (Register)

Join Partners and Aunt Bertha on October 20 at 1 p.m. to learn more about Aunt Bertha, an open social care network that helps connect people in need to resources and social programs across the United States. Aunt Bertha makes it easy for people facing social needs – and those who help others – to find and make referrals to appropriate programs and services for food, shelter, health care, work, financial assistance and more.

Try it out by visiting https://partnerslink.auntbertha.com/, and make sure to create an account for access to free tools and features.

Domestic Violence During COVID-19

Two opportunities:

  • November 9, 2020, 1 p.m.-3 p.m., (Register)
  • December 11, 2020, 1 p.m.-3 p.m. (Register)

Many of us are still home more than usual and the risk for domestic violence is high. Learn how to spot the signs of domestic violence and how to help.

Question Persuade Refer (QPR) Suicide Prevention

Four opportunities:

  • November 17, 2020 1 p.m.-3 p.m. (Register)
  • November 23, 2020, 2 p.m.-4 p.m. (Register)
  • December 1, 2020, 2 p.m.-4 p.m. (Register)
  • December 16, 2020, 2 p.m.-4 p.m. (Register)

Many of us are isolated because of social distancing. Many have experienced losses. The risk of suicide is higher than ever. This training teaches the skills to intervene in a suicide crisis. The maximum number of people allowed to participate in a virtual QPR training at one time is 30; registration is on a first come first serve basis.

Risk & Resilience Buffering Toxic Stress

November 18, 2020, 2 p.m.-5 p.m. (Register)

This training provides information about how early childhood stress and trauma can result in negative outcomes in areas of learning, behavior and health throughout the lifespan. The definition of early childhood mental health as promoting healthy social emotional development through nurturing young minds from birth throughout early childhood is the core principle of this training. We will cover the following three modules during the training:

  • Module 1 – Early Brain Development and Self-Regulation.
  • Module 2 – Toxic Stress & Effects on Early Development.
  • Module 3 – Building Resilience Through Early Relationships.

Community Resilience Model (CRM)

Two opportunities:

  • November 19, 2020, 1 p.m.-3 p.m. (Register)
  • December 9, 2020, 2 p.m.-4 p.m. (Register)

The Community Resilience Model® teaches participants about the impact of trauma and chronic stress on the nervous system, behavior, and long-term health. Participants learn how to reset the nervous system with easy to learn, concrete, coping skills. One of the goals of CRM® is to create trauma-informed and resilient communities.

Human Trafficking During Quarantine: Keeping Our Children Safe

Two opportunities:

  • November 20, 2020, 1 p.m.-3 p.m. (Register)
  • December 14, 2020, 1 p.m.-3 p.m. (Register)

Many of us are still working from home and our children may be learning from home as well. Children may spend more time online than usual. Learn about trafficking and how to keep our children safe.

Provider Alerts

Provider Alerts are sent to all providers who subscribed to receive Partners’ Provider Communications. Published alerts are available on the Provider Knowledge Base at https://providers.partnersbhm.org/provider-alert-archive/. To subscribe to Partners’ various communications, please visit https://www.partnersbhm.org/subscribe/.

State News/COVID-19 Updates

Providers are reminded to check Partners’ COVID-19 provider webpage and the NCDHHS COVID-19 Guidance and Resources for Medicaid Providers for the most up-to-date information. If you have questions, please email your provider account specialist or the Provider Network Contacts at pas@partnersbhm.org.

NCDHHS Launches SlowCOVIDNC Exposure Notification App: Help slow the spread of COVID-19 with the North Carolina Department of Health and Human Services (NCDHHS) SlowCOVID19 Exposure Notification App. Learn about the app and how it works.

DMH/DD/SAS Virtual Town Hall Meetings: Members, families and advocates can tell NCDHHS ways to improve the state’s behavioral health and intellectual and developmental disabilities system during a virtual town hall meeting on October 29, 2020 at 6:00 p.m. You can access the meeting by going to the NC Governor’s Institute Facebook Live page at the time and date of the event. To learn more and submit questions, visit https://www.ncdhhs.gov/divisions/mental-health-developmental-disabilities-and-substance-abuse/virtual-town-hall-meetings or email Suzanne.Thompson@dhhs.nc.gov.

Olmsted Meetings: Olmstead stakeholder meeting(s) are continuing at this time. NCDHHS is encouraging participation as it is important for individuals with lived experience and other stakeholders to have a voice in these Olmstead initiatives. A list of upcoming meetings and additional information can be found at https://www.ncdhhs.gov/about/department-initiatives/nc-olmstead.

Hope4Healers: NC health care professionals, EMS, first responders, childcare workers, other front-line staff and their families can call Hope4Healers (919-226-2002) to access licensed mental health professionals offering confidential counseling. Hope4Healers is a collaboration between NCDHHS and the North Carolina Psychological Association.

Medicaid Bulletins: All bulletin articles, including those related to COVID-19, are available on the DHB webpage.

NCTracks: Providers are encouraged to review NCTracks communications. To subscribe to NCTracks communications, visit https://www.nctracks.nc.gov/content/public/providers/provider-communications.html.

Joint Communication Bulletins, which are issued by the NC Department of Health and Human Services, can be found at https://www.ncdhhs.gov/divisions/mhddsas/joint-communication-bulletins.

Recent Joint Communication Bulletins:

  • #J375 NC Innovations – Respite during Remote Learning
    Appendix K Part III – Bulletin
  • #J376 Session Law 2020-80 Coronavirus Relief Funding for Group Homes
    Provider Attestation Invoice FINAL
  • #J377 State-Designed Templates for Notification of Adverse Benefit Determinations (NABDs) and associated files
  • #J378 Assertive Community Treatment and Individual Placement and Support Interim Evidence-Based Practice Quality Review Protocol and attachment.
  • #J379 Addition of ASAM Requirements for the Comprehensive Clinical Assessment (CCA) and Diagnostic Assessment (DA)

Joint DMHDDSAS and DHB (NC Medicaid) COVID-19 Update Call for NC Providers:
This call occurs every first Thursday at 3:00 p.m.; check the Partners’ COVID-19 Provider webpage for weekly call-in details.

Joint DMHDDSAS and DHB (NC Medicaid) COVID-19 Update Call For BH/IDD Consumers, Family Members and Community Stakeholders:
This call occurs every fourth Monday at 2:00 p.m.; check the Partners’ COVID-19 Provider webpage for weekly call-in details.

Training, Announcements and Reminders

NC Resources for Pregnant and Parenting Women with a Substance Use Disorder: The United Way of Rutherford County and Mountain Area AHEC are sponsoring a free training, “NC Resources for Pregnant and Parenting Women with a Substance Use Disorder” on Wednesday, October 28th from 10 a.m.-11:30 a.m. The training will discuss the use of Medication Assisted Treatment (MAT) for expectant mothers with opioid use disorder among other topics. The training will help providers and service agencies with more knowledge about statewide programs and resources for pregnant women or women who are parents who have SUD. This will be a virtual training. CEUs have been applied for. The training is free, registration is required. Please visit https://mahec.net/event/64389 to register.

MindFest 2021: NAMI South Mountains NC is seeking vendors for its MindFest 2021 fundraiser. MindFest 2021 will be held Saturday, May 8, 2021 from 9 a.m.-7 p.m. at the POPS Pavilion, 153 Park Square, Forest City, NC. There will be a walk/run along the adjacent Rails to Trails, speakers, informational tables, arts and crafts, a silent auction, and many other activities for all ages. To learn more, visit https://www.smore.com/dgwb6-mindfest-2021?ref=email or reach out to Diane Krisanda by calling 828-771-6305 or email namisouthmountainsnc@gmail.com.