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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 : 8.8.3 Prior Authorization for Residential Detoxification Treatment Services

Detoxification services may be prior authorized for up to 21 days. The level of service and number of prior authorized days will be based on the substances that are abused, level of intoxication and withdrawal potential, and the client’s medical needs.
Requests for detoxification services for clients who are 20 years of age and younger and who need more than 21 days of residential detoxification require Medical Director review with documentation of medical necessity from a physician who is familiar with the client.

Texas Medicaid & Healthcare Partnership
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