Peer Recovery Support Services Supplement
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The purpose of this memorandum is to notify providers of changes to the Peer Recovery Support Services Supplement to the Mental Health Services and Addiction and Recovery Treatment Services Manuals. Changes to the supplement include:
- A definition for progress notes was added.
- Rural Health Clinics, Federally Qualified Health Centers and Hospital Emergency Departments were added as allowed providers of ARTS Peer Support Services and ARTS Family Support Partners.
- Psychiatric Residential Treatment Facilities, Therapeutic Group Homes, Therapeutic Day Treatment, Intensive In-Home, Multisystemic Therapy (MST), Functional Family Therapy (FFT), Mental Health Intensive Outpatient (MH-IOP), Mental Health Partial Hospitalization Program (MH-PHP), Assertive Community Treatment (ACT), Mobile Crisis Response, Community Stabilization, 23-Hour Crisis Stabilization and Residential Crisis Stabilization Unit (RCSU) were added as allowed providers of Mental Health Peer Support Services.
- Psychosocial Rehabilitation, MST, FFT, MH-IOP, MH-PHP, ACT, Mobile Crisis Response, Community Stabilization, 23-Hour Crisis Stabilization and RCSU were added as allowed providers of Mental Health Family Support Partners.
- Language was edited throughout the document for clarification purposes.
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PROVIDER CONTACT INFORMATION & RESOURCES |
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Virginia Medicaid Web Portal Automated Response System (ARS) Member eligibility, claims status, payment status, service limits, service authorization status, and remittance advice. |
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Medicall (Audio Response System) Member eligibility, claims status, payment status, service limits, service authorization status, and remittance advice. |
1-800-884-9730 or 1-800-772-9996 |
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KEPRO Service authorization information for fee-for-service members. |
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Provider Appeals DMAS launched an appeals portal in 2021. You can use this portal to file appeals and track the status of your appeals. Visit the website listed for appeal resources and to register for the portal. |
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Managed Care Programs Medallion 4.0, Commonwealth Coordinated Care Plus (CCC Plus), and Program of All-Inclusive Care for the Elderly (PACE). In order to be reimbursed for services provided to a managed care enrolled individual, providers must follow their respective contract with the managed care plan/PACE provider. The managed care plan may utilize different guidelines than those described for Medicaid fee-for-service individuals. |
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Medallion 4.0 |
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CCC Plus |
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PACE |
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Magellan Behavioral Health Behavioral Health Services Administrator, check eligibility, claim status, service limits, and service authorizations for fee-for-service members. |
www.MagellanHealth.com/Provider For credentialing and behavioral health service information, visit: www.magellanofvirginia.com, email: VAProviderQuestions@MagellanHealth.com,or Call: 1-800-424-4046 |
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Provider HELPLINE Monday–Friday 8:00 a.m.-5:00 p.m. For provider use only, have Medicaid Provider ID Number available. |
1-804-786-6273 1-800-552-8627 |
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Aetna Better Health of Virginia |
www.aetnabetterhealth.com/Virginia 1-800-279-1878 |
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Anthem HealthKeepers Plus |
1-800-901-0020 |
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Molina Complete Care
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1-800-424-4524 (CCC+) 1-800-424-4518 (M4) |
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Optima Family Care |
1-800-881-2166 www.optimahealth.com/medicaid |
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United Healthcare |
and www.myuhc.com/communityplan 1-844-752-9434, TTY 711 |
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Virginia Premier |
1-800-727-7536 (TTY: 711), www.virginiapremier.com |