CONTRACTOR Behavioral Health Benefits Chart. SERVICE BENEFIT LIMIT Psychiatric Inpatient Hospital Services (including physician services) As medically necessary. 24-hour Psychiatric Residential Treatment Medicaid/Standard Eligible, Age 21 and older: As medically necessary. Medicaid/Standard Eligible, Under age 21: Covered as medically necessary. Outpatient Mental Health Services (including physician services) As medically necessary. Inpatient, Residential & Outpatient Substance Abuse Benefits1 Medicaid/Standard Eligible, Age 21 and older: Limited to ten (10) days detox, $30,000 in medically necessary lifetime benefits unless otherwise described in the 2008 Mental Health Parity Act as determined by TENNCARE. Medicaid/Standard Eligible, Under age 21: Covered as medically necessary. Mental Health Case Management As medically necessary. Psychiatric- Rehabilitation Services As medically necessary. Behavioral Health Crisis Services As necessary. Lab and X-ray Services As medically necessary. Non-emergency Medical Transportation (including Non- Emergency Ambulance Transportation) Same as for physical health (see Section 2.6.1.3 above). 1When medically appropriate, services in a licensed substance abuse residential treatment facility may be substituted for inpatient substance abuse services. Methadone clinic services are not covered for adults.
Appears in 3 contracts
Samples: Contractor Risk Agreement, An Agreement, Contractor Risk Agreement
CONTRACTOR Behavioral Health Benefits Chart. SERVICE BENEFIT LIMIT Psychiatric Inpatient Hospital Hospital Services (including physician services) As medically necessary. 24-hour Psychiatric Residential Treatment Medicaid/Standard Eligible, Age 21 and older: As medically necessary. Medicaid/Standard Eligible, Under age 21: Covered as medically necessary. necessary. Outpatient Mental Health Services (including physician services) As medically necessary. Inpatient, Residential & Outpatient Substance Abuse Benefits1 Medicaid/Standard Eligible, Age 21 and older: Limited to ten (10) days detox, $30,000 in medically necessary lifetime benefits unless otherwise described in the 2008 Mental Health Parity Act as determined by TENNCARE. Medicaid/Standard Eligible, Under age 21: Covered as medically necessary. necessary. Mental Health Case Management As medically necessary. Psychiatric- Rehabilitation Services As medically necessary. Behavioral Health Crisis Services As necessary. Lab and X-ray Services As medically necessary. Non-emergency Medical Transportation (including Non- Emergency Ambulance Transportation) Same as for physical health (see Section 2.6.1.3 above). 1When medically appropriate, services in a licensed substance abuse residential treatment facility may be substituted for inpatient substance abuse services. Methadone clinic services are not covered for adults.
Appears in 1 contract
Samples: Contractor Risk Agreement
CONTRACTOR Behavioral Health Benefits Chart. SERVICE BENEFIT LIMIT Psychiatric Inpatient Hospital Services (including physician services) As medically necessary. SERVICE BENEFIT LIMIT 24-hour Psychiatric Residential Treatment Medicaid/Standard Eligible, Age 21 and older: As medically necessary. Medicaid/Standard Eligible, Under age 21: Covered as medically necessary. Outpatient Mental Health Services (including physician services) As medically necessary. Inpatient, Residential & Outpatient Substance Abuse Benefits1 Medicaid/Standard Eligible, Age 21 and older: Limited to ten (10) days detox, $30,000 in medically necessary lifetime benefits unless otherwise described in the 2008 Mental Health Parity Act as determined by TENNCAREbenefits. Medicaid/Standard Eligible, Under age 21: Covered as medically necessary. Mental Health Case Management As medically necessary. Psychiatric- Rehabilitation Services As medically necessary. Behavioral Health Crisis Services As necessary. Lab and X-ray Services As medically necessary. Non-emergency Medical Transportation (including Non- Emergency Ambulance Transportation) Same as for physical health (see Section 2.6.1.3 above). 1When medically appropriate, services in a licensed substance abuse residential treatment facility may be substituted for inpatient substance abuse services. Methadone clinic services are not covered for adults.
Appears in 1 contract
Samples: Contractor Risk Agreement