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December 2016 Texas Medicaid Provider Procedures Manual

Behavioral Health, Rehabilitation, and Case Management Services Handbook : 8 Substance Use Disorder (SUD) Services (Abuse and Dependence) : 8.8 Prior Authorization : 8.8.2 Prior Authorization for Ambulatory (Outpatient) Detoxification Treatment Services

8.8.2
Ambulatory (outpatient) detoxification services may be prior authorized for up to 21 days. The level of service and number of days that are prior authorized will be based on the substances that are abused, level of intoxication and withdrawal potential, and the client’s medical needs.

Texas Medicaid & Healthcare Partnership
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