Qualitrac now has the ability to differentiate between traditional outpatient behavioral health therapy requests and those requests for members who are residing in a facility such as a group home, residential treatment center or a juvenile detention facility. The documentation requirements remain the same and all the outpatient behavior health criteria remains the same. Please refer to the WY Medicaid CMS-1500 Manual Chapter 13 for all requirements and expectations for outpatient behavioral health requests.
What’s New:
Review Type: Residential Outpatient Services
Place of Service: Other residential facility
Type of service: Outpatient behavioral health therapy.
You can start using this new review type effective immediately. If you have any questions, please reach out to our Provider Help Desk at 833-610-1057.
There will be additional training in January, please look out for the registration announcement in Qualitrac.