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Behavioral Health Updates

Managed Care Organizations Updates as of 5/25/2022

PerformCare – IBHS Capacity Reporting

PerformCare wants to let individual and applied behavioral analysis (ABA) Intensive Behavioral Health Services (IBHS) providers know about a change we are implementing to the IBHS capacity report. The Provider Capacity Report currently displays IBHS capacity in “hours per week,” but IBHS is prescribed in hours per month.

For efficiency and consistency with the recently implemented IBHS referral process, PerformCare will update the Provider Capacity Report to reflect “hours per month.” We will send another notice once that change happens.

When reporting your weekly capacity in NaviNet®, please ensure your capacity reflects the number of monthly hours you have available for all services.

Contact your Account Executive if you have any questions or issues related to IBHS capacity reporting.

PerformCare – Updated Provider Choice Forms

PerformCare updated the following Intensive Behavioral Health Services (IBHS) provider choice forms:

Access these and other IBHS forms on PerformCare’s website.

PerformCare – Updated IBHS Written Order Form and Recommendation Guidelines

PerformCare has updated the Intensive Behavioral Health Services (IBHS) written order form and guidelines.

Access these and other IBHS documents on PerformCare’s website.

PerformCare – School-Based Behavioral Health: Mental Health and COVID-19

Teachers and students may be feeling an increase in stress, uncertainty, and other unsettling emotions due to the prolonged nature of the COVID-19 pandemic. As part of PerformCare’s series on this topic, we review common psychological reactions that impact all age groups, and provide suggestions for better managing this distress.

Our second memo of the School-Based Behavioral Health series, Mental Health and COVID-19 (PDF), includes common emotional reactions to COVID-19 as well as a list of coping strategies to help students.

Access this and other notices in this series on PerformCare’s website.

PerformCare – Information for Providers on Managing Clients with Suicidal Thinking: Memo #5

A new provider memo, Information for Providers on Managing Clients with Suicidal Thinking: Memo #5 (PDF), is now available.

This memo covers fluid vulnerability theory, which in short reflects that high-risk states vary frequently, and are highly individualized based on a complex interaction between affective, physiological, cognitive, and environmental factors for each person with suicidal thinking. Individuals with chronic suicidal thinking have a suicidal mode, which becomes activated at times of high risk. Use of fluid vulnerability theory is a mechanism for understanding suicide risk over both short and longer periods of time, and it is grounded in cognitive therapy.

Access this memo and other memos in this series on PerformCare’s website.

Beacon Health Options of Pennsylvania – Monthly Provider Newsletter

May ValueAddedIssue Highlights:

  • Mental Health Professionals: Remember to Take Care of Yourselves
  • Join Us for COVID-19 Discussion Meetings
  • Note to Prescribers: Discussing Potential Side Effects
  • Avality Essentials
  • IBHS Corner

And much more!

Community Behavioral Health (CBH) – Provider Bulletin 22-10: Place of Service 02 and Modifier 95 for Telehealth Service Delivery

This Bulletin is to inform Providers that, with the issuance of the Office of Mental Health and Substance Abuse Services (OMHSAS) Bulletin 21-09, the Place of Service (POS) 02 Telehealth has been added, along with the modifier 95, to denote when the service is provided by telephone or audio only.

Effective June 13, 2022, Providers who bill for a telehealth service must include the POS 02, and when the service is rendered telephone or audio only, modifier 95 must be indicated.

Community Behavioral Health (CBH) – Provider Notice: EPIC (Evidence-Based Practice and Innovation Center) EBP (Evidence-Based Practice) Program Designation Open Renewal and Application Periods

This Notice is to inform Providers about the Evidence-Based Practice and Innovation Center (EPIC) implementing new annual open renewal and open application periods for its EBP Program Designation. 

Community Behavioral Health (CBH) – Provider Bulletin 22-06: ASAM (American Society of Addiction Medicine) Value Based Payment (VBP) (Case Rate) Arrangement

This Bulletin was updated to clarify limits on smoking cessation services counting toward the ASAM 1.0 Case Rate.

Community Behavioral Health (CBH) – Provider Bulletin 22-11: ASAM 3.5 Clinically Managed High-Intensity Residential Services

This Bulletin is to inform Providers about CBH making contractual changes to reflect the new PROMISe enrollment for ASAM 3.5 (Clinically Managed High-Intensity Residential Services).