Department of Behavioral Health and Developmental Services (DBHDS) Crisis Services Regulatory Updates and Related Provider Enrollment Requirements for Comprehensive Crisis and Transition Services
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The purpose of this bulletin is to alert providers to Department of Behavioral Health and Developmental Services (DBHDS) regulatory updates that affect licensed crisis providers. The Mental Health Services Manual requires that all DBHDS licensed providers of Medicaid services adhere to DBHDS licensing rules as they relate to service provision. Details on this regulatory update are available on the Virginia Regulatory Town Hall at https://townhall.virginia.gov/L/viewaction.cfm?actionid=6475. These regulations were effective July 17, 2024. Providers have up to ninety days from July 17, 2024 to fully comply with the regulations. Additional details are available on the DBHDS Office of Licensing webpage at https://dbhds.virginia.gov/clinical-and-quality-management/office-of-licensing/.
DMAS will be updating the Mental Health Services Manual to align with these regulatory changes.
23-Hour Crisis Stabilization
Effective July 17, 2024, DBHDS is requiring that providers of 23-Hour Crisis Stabilization (S9485) services (also referred to as Crisis Receiving Centers) obtain one of the following licenses:
MH Center-Based Crisis Receiving Center for Adults (02-040) and/or
MH Center-Based Crisis Receiving Center Children and Adolescents (02-041)
Current providers of 23-Hour Crisis Stabilization services have 90 days from July 17, 2024 to obtain the appropriate DBHDS license for the service they are providing and must complete the DMAS enrollment process with the new license by October 17, 2024.
Providers of 23-Hour Crisis Stabilization are required to do all of the following actions by October 17, 2024:
Obtain new DBHDS license (02-040 and/or 02-041)
Enroll in the Virginia Department of Medical Assistance Services Online Provider Enrollment System (DMAS Provider Enrollment) as a 23-Hour Crisis Stabilization provider with the following:
Provider Type: 156 or 456
Provider Specialty: 921
Submit with application newly obtained DBHDS license (02-040, 02-041 or both).
Providers currently enrolled with the above provider type(s) and specialty for 23-Hour Crisis Stabilization must update their enrollment with the new DBHDS license (02-040 and/or 02-041)
Providers that do not meet the October 17, 2024 deadline of enrolling as a 23-Hour Crisis Stabilization provider with the new DBHDS license and above provider type(s) and specialty, will not be eligible to provide the service or be reimbursed by DMAS or its contractors until enrollment is complete and approved. DMAS MCOs may have additional steps that providers must complete before a provider is eligible for reimbursement. Please contact the MCO directly to determine whether additional requirements apply.
Mobile Crisis Response, Residential Crisis Stabilization Unit (RCSU) and Community Stabilization
Providers of Mobile Crisis Response (H2011), RCSU (H2018) and Community Stabilization (S9482) services must also ensure that they are properly enrolled with the correct provider types and provider specialty by October 17, 2024. Providers can verify their enrollments through the DMAS Online Provider Enrollment System (DMAS Provider Enrollment). See the chart below for information on the required license, provider type and provider specialty for each service. In addition, providers of Mobile Crisis Response (H2011) and Community Stabilization (S9482) must submit all Memorandum of Understanding(s) (MOU) or contract(s) with the regional crisis hubs for the 7/1/2024 term. MOUs and contracts must continue to be submitted through the DMAS Online Provider Enrollment System at a minimum of annually or when updated, whichever comes first.
Service | DBHDS License | Provider Type | Provider Specialty | MOU or contract |
Mobile Crisis Response |
| 156 or 456 | 920 | All current MOU(s) or contract(s) must be on file in the DMAS Provider Enrollment System |
RCSU |
| 077 | 177 | n/a |
Community Stabilization |
| 156 or 456 | 902 | All current MOU(s) or contract(s) must be on file in the DMAS Provider Enrollment System |
Providers that do not meet the October 17, 2024 deadline of ensuring they are properly enrolled with the above provider type(s) and specialty for the services they are providing, will not be eligible to provide the service or be reimbursed by DMAS or its contractors until enrollment is complete and approved. DMAS MCOs may have additional steps that providers must complete before a provider is eligible for reimbursement. Please contact the MCO directly to determine whether additional requirements apply.
Questions?
Questions related to provider enrollments can be directed to Provider Enrollment Services at VAMedicaidProviderEnrollment@gainwelltechnologies.com or phone 1-888-829-5373.
Questions related to DBHDS regulations effect on licensing for crisis services can be directed to DBHDS at crisis_services@dbhds.virginia.gov
Questions related to DMAS provider requirements for crisis services can be sent to enhancedbh@dmas.virginia.gov
Virginia Medicaid Web Portal Automated Response System (ARS) Member eligibility, claims status, payment status, service limits, service authorization status, and remittance advice. | |
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 |
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. | |
Managed Care Programs Cardinal Care Managed Care 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. | |
Cardinal Care Managed Care | https://www.dmas.virginia.gov/for-providers/managed-care/cardinal-care-… |
PACE | |
Acentra Health Behavioral Health Services
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Provider Enrollment | In-State: 804-270-5105 Out of State Toll Free: 888-829-5373 Email: VAMedicaidProviderEnrollment@gainwelltechnologies.com |
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 |
Aetna Better Health of Virginia | https://www.aetnabetterhealth.com/virginia/providers/index.html 1-800-279-1878
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Anthem HealthKeepers Plus | 1-800-901-0020
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Molina Complete Care
| 1-800-424-4524 https://www.molinahealthcare.com/providers/va/medicaid/home.aspx
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Sentara Community Plan | 1-800-881-2166 https://www.sentarahealthplans.com/providers
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United Healthcare | 1-844-284-0149
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Dental Provider DentaQuest | 1-888-912-3456 |