Common use of Mental Health and Substance Use Disorder Benefits Clause in Contracts

Mental Health and Substance Use Disorder Benefits. Blue Shield’s Mental Health Service Administrator (MHSA) administers Mental Health Services and Substance Use Disorder Services from MHSA Participating Providers for Members in California. See the Out-of-area services section for an explanation of how Benefits are administered for out-of-state services. The MHSA Participating Provider must get prior authorization from the MHSA for all non- emergency Hospital admissions for Mental Health Services and Substance Use Disorder Services, and for certain outpatient Mental Health and Substance Use Disorder Services. See the Medical management section for more information about prior authorization. The MHSA Participating Providers network is separate from Blue Shield’s Participating Provider network. Visit xxxxxxxxxxxx.xxx and click on Find a Doctor to access the MHSA Participating Provider network. Benefits are available for professional office visits, including Physician office visits, for the diagnosis and treatment of Mental Health Conditions and Substance Use Disorder Conditions in an individual, Family, or group setting. Benefits are also available for telebehavioral health online counseling services, psychotherapy, and medication management with a mental health or substance use disorder provider.