Medical Policy | Revision |
|---|---|
| Psychiatric Intensive Outpatient Programs | New policy developed. BCBSNC will provide coverage for Psychiatric Intensive Outpatient Programs (IOP) when it is determined to be medically necessary because the medical criteria and guidelines listed within the policy are met. Medical Director review 3/2024. Notification given on 4/1/2024 for effective date 7/1/2024. |
| Psychiatric Partial Hospitalization Programs | New policy developed. BCBSNC will provide coverage for Psychiatric Partial Hospitalization Programs (PHP) when it is determined to be medically necessary because the medical criteria and guidelines listed within the policy are met. Medical Director review 3/2024. Notification given on 4/1/2024 for effective date 7/1/2024. |
| Residential Treatment | Reinstated medical policy. Updated definition of residential treatment to include “is licensed under applicable state laws to provide the services for which authorization or coverage is being requested.” Updated related policies. Updated coverage criteria, description, and references based on updated literature and current standards of care. Medical director review 3/2024. Notification given 4/1/2024 for effective date 7/1/2024. |
| Substance Use Disorder Intensive Outpatient Programs | New policy developed. BCBSNC will provide coverage for Intensive Outpatient Programs (IOP) for Substance Use Disorder when it is determined to be medically necessary because the medical criteria and guidelines listed within the policy are met. Medical Director review 3/2024. Notification given on 4/1/2024 for effective date 7/1/2024. |
| Substance Use Disorder Partial Hospitalization Programs | New policy developed. BCBSNC will provide coverage for Partial Hospitalization (PHP) for Substance Use Disorder when it is determined to be medically necessary because the medical criteria and guidelines listed within the policy are met. Medical Director review 3/2024. Notification given on 4/1/2024 for effective date 7/1/2024. |
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