Behavioral Health Clinical Guidelines & Medical Policies

Determining Medical Necessity

PCHP uses the following resources to determine medical necessity:

PCHP uses the following clinical elements for determining medical necessity for behavioral health services:

  • Assessment of local delivery system and network access
  • Co-occurring conditions (SUD, medical, IDD)
  • Coordination between BH and medical providers
  • Current medications or medication changes
  • Current symptoms (e.g., risk to self/others, psychosis, active substance use, relapse risk)
  • Current treatment plan
  • Diagnosis
  • Discharge plan
  • Family and social supports
  • Functional impairment
  • Presenting problem/reason for referral
  • Psychosocial situation and home environment
  • Response to treatment or barriers to treatment

Request for SUD services may be reviewed using ASAM criteria. Reviews will be largely structured around the 6 Dimensions. Providers will be expected to identify the level of care requested based on ASAM LOCs.

When requesting authorization for court-ordered care, providers must submit a copy of the court order to PCHP. If a court order is not received, PCHP will process the request using appropriate medical necessity criteria.