Project Bravo Phase II: New Behavioral Health Services Available on December 1, 2021

On December 1, 2021, seven (7) new enhanced behavioral health services will become effective.


These services include:

1. Multisystemic Therapy (MST)

  • Billing Code H2033
  • Authorizations: Authorizations may be submitted on or after 12/1/2021

MST is an intensive family and community-based treatment, which addresses the externalizing behaviors of youth with significant clinical impairment in disruptive behavior, mood, and/or substance use. MST service providers must be licensed by The Department of Behavioral Health and Developmental Services (DBHDS) as a provider of Intensive In-Home Services (License #: 05- 001) and be credentialed with the individual’s Medicaid Managed Care Organization (MCO) for individual enrolled in Medicaid managed care or the Fee-for-Service (FFS) contractor for individuals in FFS.

2. Functional Family Therapy (FFT)

  • Billing Code H0036
  • Authorizations: Authorizations may be submitted on or after 12/1/2021

FFT is a short-term, evidence-based treatment program targeting youth between the ages of 11 - 18 who have received referral for the treatment of behavioral or emotional problems including co-occurring substance use disorders by the juvenile justice, behavioral health, school, or child welfare systems. The FFT model serves as a step-down or diversion from higher levels of care and seeks to understand and intervene with the youth within their network of systems including, family, peers, school and neighborhood/community.

3. Mobile Crisis Response

  • Billing Code: H2011
  • Important Note: Crisis Intervention (H0036) is transitioning to Mobile Crisis Intervention (H2011)
  • Authorizations: Existing authorizations for H0036 that extend past 11/30/2021 will be transferred to H2011 by Optima Health

Mobile Crisis Response provides rapid response, assessment and early intervention to individuals experiencing a behavioral health crisis. This service is provided 24 hours a day, seven days a week. The purpose of this service includes prevention of acute exacerbation of symptoms, prevention of harm to the individual or others, provision of quality intervention in the least restrictive setting, and development of an immediate plan to maintain safety in order to prevent the need for a higher level of care.

4. Community Stabilization

  • Billing Code: H2011
  • Important Note: Crisis Stabilization (H2019) transitioning to Community Stabilization (S9482)
  • Authorizations: Existing authorizations for H2019 that extend past 11/30/2021 will be transferred to S9482 by Optima Health

Community Stabilization services are short-term and designed to support an individual and their natural support system following contact with an initial crisis response service or as a diversion to a higher level of care. Providers deliver community stabilization services in an individual’s natural environment and provide referral and linkage to other community-based services at the appropriate level of care. Interventions may include, brief therapeutic and skill building interventions, engagement of natural supports, interventions to integrate natural supports in the de-escalation and stabilization of the crisis, and coordination of follow-up services.

5. 23-Hour Crisis Stabilization

  • Billing Code S9485

23-Hour Crisis Stabilization provides a period of up to 23 hours in a community-based setting for crisis stabilization that provides assessment and stabilization interventions to individuals experiencing a behavioral health crisis. This service should be accessible 24/7 and is indicated for those situations wherein an individual is in an acute crisis and requires a safe environment for observation and assessment prior to determination of whether admission to an inpatient or residential crisis stabilization unit setting is necessary.

6. Residential Crisis Stabilization Unit (RCSU)

  • Billing Code: H2018
  • Important Note: Crisis Stabilization (H2019) transitioning to Residential Crisis Stabilization Unit (H2018)
  • Authorizations: Existing authorizations for H2019 that extend past 11/30/2021 will be transferred to H2018. Must submit a continued stay service request authorization no later than one business day after the end of the original service authorization end date to request continued service.

RCSUs provide short-term, 24/7, residential psychiatric/substance related crisis evaluation and brief intervention services. RCSUs serve as diversion or stepdown from inpatient hospitalization. The service supports individuals experiencing abrupt and substantial changes in behavior noted by severe impairment or acute decompensation in functioning. (Includes adult and child services)

7. Applied Behavior Analysis

  • Billing Code: H2018
  • Important Note: Behavioral Therapy (H2033) transitioning to Applied Behavior Analysis (97155, Et al.)
  • Authorizations: Existing authorizations for H2019 that extend past 11/30/2021 will be transferred to H2018. Must submit a continued stay service request authorization no later than one business day after the end of the original service authorization end date to request continued service.

Applied Behavior Analysis means the practice of behavior analysis as established by the Virginia Board of Medicine in § 54.1-2900 as the design, implementation, and evaluation of environmental modifications using behavioral stimuli and consequences, to produce socially significant improvement in human behavior, including the use of direct observation, measurement, and functional analysis of the relationship between environment and behavior.


Resources

It is strongly encouraged that you visit the DMAS website for complete service descriptions, details regarding licensing requirements as well as to learn any additional actions that may be required for implementation, reimbursement or existing authorizations for transitioning services that extend beyond 11/30/2021 for the new enhanced behavioral health services b Project BRAVO. You may also contact your behavioral health contract manager to address any Optima Health provider network related concerns.

Hampton Roads: Janaki Smith, JXSMITH@sentara.com, (757) 805-1815

Central: Chris Hamilton, CSHAMIL1@sentara.com, (804) 510-7407

Western: Randy Hoffman, rchoffma@sentara.com, (540) 560-5219

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