CSHCN 2009 > Hospital > Inpatient Services

22.3.1.1 Inpatient Behavioral Health

The purpose of providing inpatient services is to provide resources for behavioral health crisis stabilization while efforts are made to transfer the client to a more appropriate program, where the client may receive the necessary psychiatric/psychological treatment. Coverage is limited to inpatient assessment and crisis stabilization and should be followed by referral to an appropriate mental health program. Coverage is limited to a maximum of 5 days per calendar year. These 5 days count against the 60-day inpatient hospital maximum per calendar year.

Inpatient Behavioral Health Prior Authorization Requirements

Inpatient admissions for behavioral health crisis stabilization must be prior authorized. Requests must be received by the TMHP-CSHCN Services Program on the CSHCN Services Program Prior Authorization Request for Inpatient Pyschiatric Care form before or on the day of the client's admission, unless the admission is after 5 p.m., or on a holiday, or a weekend. In these cases, the TMHP-CSHCN Services Program must receive it by 5 p.m. on the next business day following admission. The TMHP-CSHCN Services Program will notify the provider of the decision in writing by fax. There may be no extensions to the 5-day limit. Crisis stabilization must be followed by a referral to an appropriate public or private mental health program.

Refer to: Section 4.3, "Prior Authorizations" for detailed information on prior authorization requirements.

Appendix B, "CSHCN Services Program Prior Authorization Request for Inpatient Pyschiatric Care,".