Provider Manual

Beacon Health Options Participating Provider Handbook

Note: Please reference the Beacon Health Options Participating Provider Handbook to review policies and procedures as well as administrative processes germane to all Beacon Health Options providers.

Chapters

• Glossary of Terms
• Chapter 1 Welcome to Maryland’s Public Behavioral Health System
• Chapter 2 Participation in the State Public Behavioral Health System
• Chapter 3 Uninsured Eligibility
• Chapter 4 General Information
• Chapter 5 Information Technology
• Chapter 6 Service Description
  • 6.01 Inpatient Hospital Psychiatric Services
  • 6.02 Residential Treatment Service
  • 6.03 MH Partial Hospitalization Services – Day Treatment
  • 6.04 Emergency Services in a Licensed Hospital Emergency Room
  • 6.05 Mobile Treatment and Assertive Community Treatment
  • 6.06 Supported Employment Services
  • 6.07 Respite Services
  • 6.08 Enhanced Support Services
  • 6.09 Therapeutic Behavioral Services
  • 6.10 Residential Crisis
  • 6.11 Occupational Therapy Services – Updates Coming Soon
  • 6.12 Psychiatric Rehabilitation Programs
  • 6.13 Residential Rehabilitation Services
  • 6.14 Interdisciplinary Team Treatment Planning
  • 6.15 Case Management Services
  • 6.16 Outpatient Mental Health Services
  • 6.16a Mental Health Assessment and Treatment in the School Setting
  • 6.17 Intensive Outpatient Treatment Services
  • 6.18 Psychological Testing Services
  • 6.19 Nursing Home Psychiatric Consultations
  • 6.20 1915(i)
  • 6.21 Reserved for Future Use
  • 6.22 Gambling Services
  • 6.23 – 6.29 Reserved for Future Use
  • 6.30 0.5 Early Intervention
  • 6.31 3.1 Low Intensity Halfway House
  • 6.32 3.3 Medium Intensity Residential Treatment
  • 6.33 3.5 High Intensity Residential Treatment
  • 6.34 3.7 Intensive ICF-A
  • 6.35 Intensive Outpatient Treatment
  • 6.36 Level 1 Assessment and Referral
  • 6.37 Level 1 Outpatient Treatment Services
  • 6.38 Level 1 Opioid Treatment Services
  • 6.38a Substance Use Disorder Assessment and Treatment in the School Setting (SUD)
  • 6.39 Partial Hospitalization
  • 6.40 Withdrawal Management
  • 6.41 Medically Managed Intensive Inpatient Services (ASAM Level 4.0) in Institutions for Mental Diseases (IMDs)
• Chapter 7 The State of Maryland’s Medical Necessity Criteria
  • 7.01 Medical Necessity Intro
  • 7.02 Adult Inpatient Criteria
  • 7.03 Child and Adolescent Inpatient Criteria
  • 7.04 RTC and Community Based RTC Level of Care
  • 7.05 Residential Crisis Services – Adult and Child
  • 7.06 Community Based Residential Care – Adult
  • 7.07 Residential Rehabilitation Program – Intensive
  • 7.08 Psychiatric Partial Hospitalization – Adult and Child
  • 7.09 Enhanced Support Services
  • 7.10 Intensive Outpatient Treatment - Adult and Child
  • 7.11 Psychiatric Rehabilitation Program – Adult
  • 7.12 Psychiatric Rehabilitation Program – Child and Adolescent
  • 7.13 Mobile Treatment – Adult
  • 7.14 Mobile Treatment – Child and Adolescent
  • 7.15 Therapeutic Behavioral Services – Child
  • 7.16 Outpatient Services
  • 7.17 Occupational Therapy Services
  • 7.18 Respite Care – Child and Adolescent
  • 7.19 Respite Care – Adult
  • 7.20 Targeted Case Management – Child and Adolescent
  • 7.21 Targeted Case Management – Adult
  • 7.22 Psychological and Neuropsychological Testing
  • 7.23 Medical Necessity Criteria Appendices
  • 7.24 Electroconvulsive Therapy
  • 7.25 Acute Neurobehavioral Unit Inpatient Mental Health
  • 7.26 1915(i)
  • 7.27 Repetitive Transcranial Magnetic Stimulation
  • 7.28 Medical Necessity Criteria for ASAM Level 4.0 Medically Monitored Intensive Inpatient Services
• Chapter 8 Services for Individuals who are Deaf and Hard of Hearing
• Chapter 9 Reserved for Future Use
• Chapter 10 Grievance and Appeals
• Chapter 11 Provider Audits
• Chapter 12 Coordination of Care
• Chapter 13 Laboratory Services
  • 13.1 SUD Laboratory Services
• Chapter 14 Pharmacy
• Chapter 15 Transportation
• Chapter 16 Medicaid Waivers
• Chapter 17 Maryland Provider Billing Manual
  • Chapter 17 Addendum: Emergency Petition Billing Manual - Coming Soon
• Chapter 18 Reserved for Future Use
• Chapter 19 Outcomes Measurement System

Appendices

• Appendix A: Certificate of Need for Services Rules and Guidelines
• Appendix B: Eligibility Verification Process
• Appendix C: ASAM Criteria
• Appendix D: Beacon Health Options Maryland Glossary of Terms
• Appendix E: Medicaid Coverage Groups
• Appendix F: Reserved for Future Use
• Appendix G: Reserved for Future Use
• Appendix H: Medicaid and Medicare Issues
• Appendix I: Reserved for Future Use
• Appendix J: Reserved for Future Use
• Appendix K: Emergency Room Consultation Procedures
• Appendix L: Excluded Diagnoses
• Appendix M: State Approved Medicaid Provider Types for the PBHS
• Appendix N: OMS Interview Guide (PDF)