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The purpose of this bulletin is to provide Behavioral Health Providers, Acentra Health, Cardinal Care Managed Care Organizations (CCMCOs) and Gainwell Technologies with provider enrollment information for the new Collaborative Behavioral Health Services being implemented as part of Virginia Medicaid's redesign of Community Mental Health Rehabilitative Services (CMHRS). As previously communicated, the redesigned services will go live on July 1, 2027. To support a smooth transition, provider enrollment for the new services will begin on October 1, 2026. This bulletin outlines the Department of Behavioral Health and Developmental Services (DBHDS) licensing and accreditation requirements that providers must meet to enroll in each new provider specialty (PS) with the Department of Medical Assistance Services (DMAS).

For additional information regarding DBHDS licenses for Collaborative Behavioral Health Services, please see the DBHDS bulletin located here.

Provider Enrollment Timeline

DMAS, in coordination with Gainwell Technologies, will open enrollment for the new Collaborative Behavioral Health Services provider specialties on October 1, 2026 through the Provider Services Solution (PRSS). Providers are strongly encouraged to begin gathering their DBHDS licensing and accreditation documentation now so that enrollment can be completed well in advance of the July 1, 2027, go-live date. Enrolling early will help ensure there is no disruption to service authorizations or claims payments when the new services begin and the old services end. 

To allow enough time for all steps required before the July 1, 2027, implementation date, provider specialty activation in PRSS, CCMCO credentialing, and service authorization transitions, DMAS strongly encourages providers to submit their enrollment applications to PRSS by January 29, 2027. Submitting by this date gives DMAS, Gainwell, and the CCMCOs the time needed to complete these steps and helps preserve continuity of care for members.

Enrollment applications will continue to be accepted after January 29, 2027. However, for applications submitted after that date, DMAS cannot guarantee that enrollment, CCMCO credentialing, and service authorization transitions will be fully completed before July 1, 2027, which may affect a provider's ability to serve and bill for member services when the new services begin.

Accreditation

Except where noted below, providers enrolling in the new Community Psychiatric Support and Treatment (CPST) and Mental Health Clubhouse specialties will be asked to submit, at the time of enrollment, either proof of accreditation intent or actual proof of accreditation from one of the applicable accrediting bodies identified for each specialty. “Proof of accreditation intent” may be demonstrated by documentation showing that the provider has initiated the accreditation process with a recognized accrediting body.

Provider Enrollment by Provider Specialty

Below are the provider types, specialties, taxonomies, licenses, and accreditation information that PRSS will collect during enrollment for each new Collaborative Behavioral Health Service. All licensing references are for DBHDS licenses issued under 12VAC35-105.

Community Psychiatric Support and Treatment

CPST providers will be asked to submit  documentation of accreditation intent or actual proof of accreditation from one of the following accrediting bodies: (1) Council on Accreditation (COA), (2) Commission on Accreditation of Rehabilitation Facilities (CARF) or (3) The Joint Commission (TJC). Providers have 18 months from July 1, 2027, to become fully accredited. Allowable and approved accreditations for CPST can be found here.

The CPST Clinical Director will also enroll individually in PRSS and be affiliated with the CPST agency's enrollment. Additional guidance on enrolling the CPST Clinical Director will be provided at a later date.

Community Psychiatric Support and Treatment – Youth, School Setting

Community Psychiatric Support and Treatment – Youth, Community

Community Psychiatric Support and Treatment – Adult, Community

Mental Health Clubhouse Services

Mental Health Clubhouse Services providers will be asked to submit accreditation documentation from either Clubhouse International or CARF (see chart below). Providers accrediting directly with Clubhouse International have four years from July 1, 2027, to achieve accreditation. Providers with existing CARF "Community Integration" accreditation (see criteria below) have five years from July 1, 2027, to achieve Clubhouse International accreditation.

Coordinated Specialty Care (CSC)

Existing Case Management – Mental Health Provider Specialty (PS) 900 Enrollments

As part of the enrollment implementation, DMAS is currently reviewing PS 900 enrollments to ensure compliance with regulation 12VAC30-50-420 (Case management services for seriously mentally ill adults and emotionally disturbed children), which restricts Mental Health Case Management to Community Services Boards.

All PS 900 enrollments for providers that are not Community Services Boards will be voided or terminated. Where PS 900 is a provider's only active enrollment, the provider may be terminated from enrollment. Providers affected will receive a 30-day advance written notice from PRSS prior to any void or termination action, consistent with DMAS' current enrollment process.  Providers with questions about a specific PS 900 enrollment should contact DMAS Provider Enrollment using the resources listed at the end of this bulletin.

Additional Information

Additional information regarding policy finalization, provider training, DMAS provider enrollment, CCMCO contracting, service authorization transitions, and member care coordination will be communicated and posted over the coming months.

Questions?

Additional details including draft manuals, presentations, and a frequently asked questions (FAQ) document are located on the DMAS Behavioral Health Services Redesign webpage. Information related to DBHDS licensing and accreditation and training opportunities will be communicated directly to current providers by DBHDS.

Providers can direct questions related to Behavioral Health Services Redesign enrollment requirements to the DMAS Behavioral Health Division at enhancedbh@dmas.virginia.gov. In addition, DMAS hosts Provider Open Office Hours dedicated to Behavioral Health Services Redesign questions from providers twice a month.

To avoid disruption to claims payment through FFS and the MCOs providers must periodically check the DMAS provider portal, also known as the Provider Services Solution (PRSS), to ensure that the provider's enrollment, contact information, and license information is up to date, for all of the provider's respective service locations. Under federal rules, MCOs and DMAS are prohibited from paying claims to network providers who are not enrolled in PRSS. Additional information is provided on the MCO Provider Network Resources webpage and includes links to resources, tutorials and contact information to reach Gainwell with any provider enrollment or revalidation related questions.  Dental providers should continue to enroll directly through the DMAS Dental Benefits Administrator, DentaQuest.