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July 22, 2019

By: Meghan M. Linvill McNab and

On May 30, 2019, the Indiana Health Coverage Programs (“IHCP”) released a bulletin (BT201929) stating that it is modifying coverage of crisis intervention, intensive outpatient treatment (“IOT”) and peer recovery services for Indiana Medicaid, effective July 1, 2019.  The two notable changes are that IOT and peer recovery services will no longer be restricted to Medicaid Rehabilitation Option (“MRO”) members.  Historically, services restricted to MRO could only be provided by community mental health centers. Therefore, by expanding IOT and peer recovery services beyond MRO, other providers can now offer these services, further facilitating access to mental health services along the full continuum of care.  The other notable change is that IOT, peer recovery and crisis intervention services will no longer be carved out of managed care.  The bulletin further describes the provider requirements, descriptions and billing information for all three services.

It should also be noted that in June 2017, FSSA issued a bulletin indicating that intensive outpatient program (“IOP”) services would be added to all Medicaid managed care benefit packages. The new 2019 bulletin overrides the 2017 bulletin, seemingly in an effort to provide one service definition across the fee for service and managed care delivery systems for all intensive outpatient treatment programming.

For questions regarding this bulletin or Indiana Medicaid coverage of mental health services please contact Meghan M. Linvill McNab or Amanda K. Schipp.