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  5. Medical Policies - Behavioral Health

Medical Policies - Behavioral Health

  • 23-Hour Crisis Stabilization Medicaid - Behavioral Health 33

    PDF, 280 KBLast Updated: 05/13/2025

    PDF, 280 KBLast Updated: 05/13/2025

  • Applied Behavioral Analysis Medicaid - Behavioral Health 37

    PDF, 271 KBLast Updated: 05/13/2025

    PDF, 271 KBLast Updated: 05/13/2025

  • ARTS Family Support Partners Medicaid - Behavioral Health 41

    PDF, 332 KBLast Updated: 05/21/2025

    PDF, 332 KBLast Updated: 05/21/2025

  • ARTS Peer Support Services Medicaid - Behavioral Health 40

    PDF, 328 KBLast Updated: 05/13/2025

    PDF, 328 KBLast Updated: 05/13/2025

  • ASAM Level 2.1 Intensive Outpatient Services for Substance Abuse (Adolescent) Concurrent Medicaid - Behavioral Health 50

    PDF, 312 KBLast Updated: 05/13/2025

    PDF, 312 KBLast Updated: 05/13/2025

  • ASAM Level 2.1 Intensive Outpatient Services for Substance Abuse (Adolescent) Initial Medicaid - Behavioral Health 48

    PDF, 309 KBLast Updated: 05/13/2025

    PDF, 309 KBLast Updated: 05/13/2025

  • ASAM Level 2.1 Intensive Outpatient Services for Substance Abuse (Adult) Concurrent Medicaid - Behavioral Health 49

    PDF, 317 KBLast Updated: 05/13/2025

    PDF, 317 KBLast Updated: 05/13/2025

  • ASAM Level 2.1 Intensive Outpatient Services for Substance Abuse (Adult) Initial Medicaid - Behavioral Health 08

    PDF, 313 KBLast Updated: 05/13/2025

    PDF, 313 KBLast Updated: 05/13/2025

  • ASAM Level 2.5 Partial Hospitalization Services for Substance Abuse (Adolescent) Concurrent Medicaid - Behavioral Health 53

    PDF, 310 KBLast Updated: 05/13/2025

    PDF, 310 KBLast Updated: 05/13/2025

  • ASAM Level 2.5 Partial Hospitalization Services for Substance Abuse (Adolescent) Initial Medicaid - Behavioral Health 51

    PDF, 310 KBLast Updated: 05/13/2025

    PDF, 310 KBLast Updated: 05/13/2025

  • ASAM Level 2.5 Partial Hospitalization Services for Substance Abuse (Adult) Concurrent Medicaid - Behavioral Health 52

    PDF, 319 KBLast Updated: 05/13/2025

    PDF, 319 KBLast Updated: 05/13/2025

  • ASAM Level 2.5 Partial Hospitalization Services for Substance Abuse (Adult) Initial Medicaid - Behavioral Health 09

    PDF, 312 KBLast Updated: 05/13/2025

    PDF, 312 KBLast Updated: 05/13/2025

  • ASAM Level 3.1 Clinically Managed Low Intensity Residential Treatment for Substance Abuse (Adolescent) Concurrent Medicaid - Behavioral Health 56

    PDF, 313 KBLast Updated: 05/13/2025

    PDF, 313 KBLast Updated: 05/13/2025

  • ASAM Level 3.1 Clinically Managed Low Intensity Residential Treatment for Substance Abuse (Adolescent) Initial Medicaid - Behavioral Health 54

    PDF, 310 KBLast Updated: 05/13/2025

    PDF, 310 KBLast Updated: 05/13/2025

  • ASAM Level 3.1 Clinically Managed Low Intensity Residential Treatment for Substance Abuse (Adult) Concurrent Medicaid - Behavioral Health 55

    PDF, 292 KBLast Updated: 05/13/2025

    PDF, 292 KBLast Updated: 05/13/2025

  • ASAM Level 3.1 Clinically Managed Low Intensity Residential Treatment for Substance Abuse (Adult) Initial Medicaid - Behavioral Health 10

    PDF, 288 KBLast Updated: 05/13/2025

    PDF, 288 KBLast Updated: 05/13/2025

  • ASAM Level 3.3 Clinically Managed Population Specific High-Intensity Residential Services for Substance Abuse (Adult) Concurrent Medicaid - Behavioral Health 57

    PDF, 320 KBLast Updated: 05/13/2025

    PDF, 320 KBLast Updated: 05/13/2025

  • ASAM Level 3.3 Clinically Managed Population Specific High-Intensity Residential Services for Substance Abuse (Adult) Initial Medicaid - Behavioral Health 11

    PDF, 290 KBLast Updated: 05/13/2025

    PDF, 290 KBLast Updated: 05/13/2025

  • ASAM Level 3.5 Clinically Managed High-Intensity Residential Services for Substance Abuse (Adult) Concurrent Medicaid - Behavioral Health 58

    PDF, 293 KBLast Updated: 05/13/2025

    PDF, 293 KBLast Updated: 05/13/2025

  • ASAM Level 3.5 Clinically Managed High-Intensity Residential Services for Substance Abuse (Adult) Initial Medicaid - Behavioral Health 12

    PDF, 293 KBLast Updated: 05/13/2025

    PDF, 293 KBLast Updated: 05/13/2025

  • ASAM Level 3.5 Clinically Managed Medium-Intensity Residential Services for Substance Abuse (Adolescent) Concurrent Medicaid - Behavioral Health 59

    PDF, 273 KBLast Updated: 05/13/2025

    PDF, 273 KBLast Updated: 05/13/2025

  • ASAM Level 3.5 Clinically Managed Medium-Intensity Residential Services for Substance Abuse (Adolescent) Initial Medicaid - Behavioral Health 13

    PDF, 317 KBLast Updated: 05/13/2025

    PDF, 317 KBLast Updated: 05/13/2025

  • ASAM Level 3.7 Medically Monitored High Intensity Inpatient Services (Adolescent) Concurrent Medicaid - Behavioral Health 44

    PDF, 279 KBLast Updated: 05/13/2025

    PDF, 279 KBLast Updated: 05/13/2025

  • ASAM Level 3.7 Medically Monitored High Intensity Inpatient Services (Adolescent) Initial Medicaid - Behavioral Health 42

    PDF, 276 KBLast Updated: 05/13/2025

    PDF, 276 KBLast Updated: 05/13/2025

  • ASAM Level 3.7 Medically Monitored Intensive Inpatient Admission for Substance (Adult) Concurrent Medicaid - Behavioral Health 43

    PDF, 318 KBLast Updated: 05/13/2025

    PDF, 318 KBLast Updated: 05/13/2025

  • ASAM Level 3.7 Medically Monitored Intensive Inpatient Admission for Substance (Adult) Initial Medicaid - Behavioral Health 06

    PDF, 319 KBLast Updated: 05/13/2025

    PDF, 319 KBLast Updated: 05/13/2025

  • ASAM Level 4.0 Medically Managed Intensive Inpatient Admission for Substance Abuse (Adolescent) Concurrent Medicaid - Behavioral Health 47

    PDF, 304 KBLast Updated: 05/13/2025

    PDF, 304 KBLast Updated: 05/13/2025

  • ASAM Level 4.0 Medically Managed Intensive Inpatient Admission for Substance Abuse (Adolescent) Initial Medicaid - Behavioral Health 45

    PDF, 299 KBLast Updated: 05/13/2025

    PDF, 299 KBLast Updated: 05/13/2025

  • ASAM Level 4.0 Medically Managed Intensive Inpatient Admission for Substance Abuse (Adult) Concurrent Medicaid - Behavioral Health 46

    PDF, 310 KBLast Updated: 05/13/2025

    PDF, 310 KBLast Updated: 05/13/2025

  • ASAM Level 4.0 Medically Managed Intensive Inpatient Admission for Substance Abuse (Adult) Initial Medicaid - Behavioral Health 07

    PDF, 308 KBLast Updated: 05/13/2025

    PDF, 308 KBLast Updated: 05/13/2025

  • Assertive Community Treatment (ACT) Medicaid - Behavioral Health 28

    PDF, 286 KBLast Updated: 05/13/2025

    PDF, 286 KBLast Updated: 05/13/2025

  • Community Stabilization Medicaid - Behavioral Health 32

    PDF, 288 KBLast Updated: 05/13/2025

    PDF, 288 KBLast Updated: 05/13/2025

  • Functional Family Therapy Medicaid - Behavioral Health 36

    PDF, 294 KBLast Updated: 05/13/2025

    PDF, 294 KBLast Updated: 05/13/2025

  • Home Music Therapy Commercial - Behavioral Health 38

    PDF, 171 KBLast Updated: 05/13/2025

    PDF, 171 KBLast Updated: 05/13/2025

  • Home Music Therapy Medicaid - Behavioral Health 38

    PDF, 209 KBLast Updated: 05/13/2025

    PDF, 209 KBLast Updated: 05/13/2025

  • Home Music Therapy Medicare - Behavioral Health 38

    PDF, 193 KBLast Updated: 05/13/2025

    PDF, 193 KBLast Updated: 05/13/2025

  • Intensive in-Home Service for Youth Medicaid - Behavioral Health 18

    PDF, 330 KBLast Updated: 05/21/2025

    PDF, 330 KBLast Updated: 05/21/2025

  • Mental Health Case Management Medicaid - Behavioral Health 22

    PDF, 282 KBLast Updated: 05/13/2025

    PDF, 282 KBLast Updated: 05/13/2025

  • Mental Health Family Support Partners Medicaid - Behavioral Health 23

    PDF, 308 KBLast Updated: 05/13/2025

    PDF, 308 KBLast Updated: 05/13/2025

  • Mental Health Intensive Outpatient Services (MH-IOP) Medicaid - Behavioral Health 29

    PDF, 344 KBLast Updated: 05/13/2025

    PDF, 344 KBLast Updated: 05/13/2025

  • Mental Health Partial Hospitalization Program (MH-PHP) Medicaid - Behavioral Health 30

    PDF, 294 KBLast Updated: 05/13/2025

    PDF, 294 KBLast Updated: 05/13/2025

  • Mental Health Peer Support Services Medicaid - Behavioral Health 19

    PDF, 271 KBLast Updated: 05/13/2025

    PDF, 271 KBLast Updated: 05/13/2025

  • Mental Health Skill-Building (MHSS) Medicaid - Behavioral Health 24

    PDF, 289 KBLast Updated: 05/13/2025

    PDF, 289 KBLast Updated: 05/13/2025

  • Mobile Crisis Response Medicaid - Behavioral Health 31

    PDF, 309 KBLast Updated: 05/13/2025

    PDF, 309 KBLast Updated: 05/13/2025

  • Multisystemic Therapy Medicaid - Behavioral Health 35

    PDF, 315 KBLast Updated: 05/13/2025

    PDF, 315 KBLast Updated: 05/13/2025

  • Psychosocial Rehabilitation Medicaid - Behavioral Health 21

    PDF, 260 KBLast Updated: 05/13/2025

    PDF, 260 KBLast Updated: 05/13/2025

  • Residential Crisis Stabilization Unit (RCSU) Medicaid - Behavioral Health 34

    PDF, 264 KBLast Updated: 05/13/2025

    PDF, 264 KBLast Updated: 05/13/2025

  • Sensory - Weighted Vest Commercial - Behavioral Health 27

    PDF, 221 KBLast Updated: 05/13/2025

    PDF, 221 KBLast Updated: 05/13/2025

  • Sensory - Weighted Vest Medicaid - Behavioral Health 27

    PDF, 228 KBLast Updated: 05/13/2025

    PDF, 228 KBLast Updated: 05/13/2025

  • Sensory - Weighted Vest Medicare - Behavioral Health 27

    PDF, 277 KBLast Updated: 05/13/2025

    PDF, 277 KBLast Updated: 05/13/2025

  • Therapeutic Day Treatment (TDT) for Youth Medicaid - Behavioral Health 20

    PDF, 329 KBLast Updated: 05/13/2025

    PDF, 329 KBLast Updated: 05/13/2025

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© Sentara Health Plans 2025, PO Box 66189, Virginia Beach, Virginia 23466

Sentara Health Plans is the trade name for Sentara Health Plans, Sentara Health Insurance Company, Sentara Health Administration, Inc., and Sentara Behavioral Health Services, Inc. Vantage Health Maintenance Organization (HMO) and Point of Service (POS) plans are issued and underwritten by Sentara Health Plans. Medicare products are administered under an agreement with Sentara Health Plans and the Centers for Medicare and Medicaid Services (CMS). Medicaid and Family Access to Medical Insurance Security (FAMIS) products are administered under an agreement with Sentara Health Plans and the Virginia Department of Medical Assistance Services (DMAS). Plus Preferred Provider Organization (PPO) products are issued and underwritten by Sentara Health Insurance Company. The Sentara Employee Assistance Program (EAP) is administered by Sentara Behavioral Health Services, Inc. Large group self-funded health plans and BusinessEDGE® plans are administered but not underwritten by Sentara Health Administration, Inc. Wellness programs are administered by Sentara Health Administration, Inc. All plans have benefit exclusions and limitations, and terms under which the policy or plan may be continued in force or discontinued. For costs and complete details of coverage, please call your broker or review this website for more information. Sentara Health Plans complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.