Updates to the Mental Health Services Manual
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The purpose of this memorandum is to notify providers of changes to Chapter IV of the Mental Health Services Manual, previously known as the Community Mental Health Services (CMHRS) Manual.
This manual update includes the following changes:
- Definitions are now found in the newly created Appendix A, Definitions. All definitions previously contained in Chapter IV have been moved to Appendix A. Appendix A also includes definitions from Chapter II and Appendices and Supplements to this manual.
- Service specific information for Intensive In-Home (IIH), Therapeutic Day Treatment (TDT), Psychosocial Rehabilitation (PSR) and Mental Health Skill-Building Services (MHSS) has been moved from Chapters II and IV to newly created Appendix H, CMHRS.
- Licensing requirements for TDT have been updated to reflect DBHDS changes to TDT licenses.
- Mental Health Skill Building units were updated to reflect current practice and DMAS regulations.
- Language was added to clarify that initial assessments must be conducted in-person.
- Service specific provider information related to Mental Health Case Management (MHCM) and Treatment Foster Care Case Management (TFC-CM) has been moved from Chapters II and IV to newly created Appendix I, Case Management.
- Staff requirements and other provider requirements specific to mental health services have been moved from Chapter II to Chapter IV.
- No substantive changes have been made to this language.
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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 Enrollment |
In-State: 804-270-5105 Out of State Toll Free: 888-829-5373 Email: VAMedicaidProviderEnrollment@gainwelltechnologies.com |
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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 1-855-270-2365 1-866-386-7882 (CCC+) |
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Anthem HealthKeepers Plus |
1-833-207-3120 1-833-235-2027 (CCC+) |
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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 |
1-800-643-2273 1-844-374-9159 (CCC+) |
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United Healthcare |
1-844-284-0149 1-855-873-3493 (CCC+) |
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Virginia Premier |
1-800-727-7536 (TTY: 711), www.virginiapremier.com |