Initial Units Authorized - Substance Use Disorders SERVICE TYPE CENPATICO AMERIGROUP UNITED● Assessment/Referral 1 within 6 rolling months Not listed Listed under Auxiliary Services (State Maximum 1 unit per day Plan) though limit not identified Individual Counseling 240 units over 6 months 60 hours over 6 months 60 hours over 6 months Maximum 9 hours per rolling 7 days COMBINED WITH GROUP INCLUDES ALL LEVEL 1 INCLUDES ALL LEVEL 1 COUNSELING Group Counseling 240 units over 6 months 60 hours over 6 months 60 hours over 6 months Maximum 9 hours per rolling 7 days COMBINED WITH INDIVIDUAL INCLUDES ALL LEVEL 1 INCLUDES ALL LEVEL 1 COUNSELING Case Management Authorization required Unlimited benefit Unlimited benefit Number of units initially authorized not specified “Unlimited benefit” noted Crisis Intervention 288 units (72 hours) per episode Unlimited benefit 60 hours over 6 months Awaiting definition of an episode. Intensive Outpatient Program (IOP) 45 days over 15 weeks 45 days over 15 weeks 45 days over 15 weeks Maximum 1 unit per day Intermediate (Short Term Residential) 14 days 14 days 14 days Maximum 1 unit per day Reintegration (Long Term Residential) 30 days 30 days 30 days Maximum 1 unit per day Peer Support 1000 units (250 hours) Unlimited benefit 1000 units (250 hours) Social Detox Not covered Not covered Not covered Residential Acute Detox Acute detoxification 5 days Level 3.7D – To Be Determined Level 3.7D – Pending State Guidelines ●Prior authorization must be obtained for services other than Level 1, Level 2, Level 3.1, Level 3.3/5 & Level 3.7D.
Initial Units Authorized - Substance Use Disorders SERVICE TYPE CENPATICO AMERIGROUP UNITED● Assessment/Referral Maximum 1 unit per day 1 within 6 rolling months Not listed Listed under Auxiliary Services (State Plan) though limit not identified Individual Counseling Maximum 9 hours per rolling 7 days 240 units over 6 months COMBINED WITH GROUP COUNSELING 60 hours over 6 months INCLUDES ALL LEVEL 1 60 hours over 6 months INCLUDES ALL LEVEL 1 Group Counseling Maximum 9 hours per rolling 7 days 240 units over 6 months COMBINED WITH INDIVIDUAL COUNSELING 60 hours over 6 months INCLUDES ALL LEVEL 1 60 hours over 6 months INCLUDES ALL LEVEL 1 Case Management Authorization required Number of units initially authorized not specified “Unlimited benefit” noted Unlimited benefit Unlimited benefit Crisis Intervention 288 units (72 hours) per episode Awaiting definition of an episode. Unlimited benefit 60 hours over 6 months Intensive Outpatient Program (IOP) Maximum 1 unit per day 45 days over 15 weeks 45 days over 15 weeks 45 days over 15 weeks Intermediate (Short Term Residential) Maximum 1 unit per day 14 days 14 days 14 days Reintegration (Long Term Residential) Maximum 1 unit per day 30 days 30 days 30 days Peer Support 1000 units (250 hours) Unlimited benefit 1000 units (250 hours) Social Detox Not covered Not covered Not covered Residential Acute Detox Acute detoxification 5 days Level 3.7D – To Be Determined Level 3.7D – Pending State Guidelines ●Prior authorization must be obtained for services other than Level 1, Level 2, Level 3.1, Level 3.3/5 & Level 3.7D.
Summary-of-Initial-Units-Authorized-060116.ACMHC_.rev-051716.docx