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December 2016 Texas Medicaid Provider Procedures Manual

Children’s Services Handbook : 2 Medicaid Children’s Services Comprehensive Care Program (CCP) : 2.8 Health and Behavior Assessment and Intervention : 2.8.2 Prior Authorization and Documentation Requirements

2.8.2
Prior authorization is not required for HBAI services.
Documentation is required for HBAI services to support the medical necessity of the initial assessment, reassessment, and intervention.
For the initial assessment, documentation must support the medical necessity of the assessment and must include the following information:
For reassessment, documentation must support the reassessment is necessary and include the following information:
For the intervention, documentation must support the necessity of the intervention and include the following information:
All documentation must include the amount of time spent in the HBAI assessment or intervention and must be documented in the client’s medical record.
All services are subject to retrospective review to ensure that the documentation in the client’s medical record supports the medical necessity of the services provided.

Texas Medicaid & Healthcare Partnership
CPT only copyright 2014 American Medical Association. All rights reserved.