What services are available to CBH members?

CBH offers behavioral health and substance use treatment services for our members through contracted health care providers. Most services can be accessed by making an appointment directly with a CBH provider. If you are calling a new provider for a first appointment, they will schedule you for an intake assessment to find out more about your needs. If you have special circumstances or need accessible services for disabilities or language needs, you can call CBH directly for assistance in scheduling your appointment. CBH staff will be sure to connect you with a provider with accessible facilities and language assistance.

Prior Authorization

Some CBH services may require a prior authorization. A prior authorization means that both your provider and CBH must approve the services before you can receive them. Your provider will be responsible for asking CBH for the prior authorization. CBH will review the provider’s request and you will be approved if you meet the medical necessity criteria for that service. If CBH denies the request for service(s), CBH will send a letter explaining the decision and those services will not be approved for payment.

For descriptions of covered services and to learn more about the covered services available to you, please review the covered services section of the member handbook. To find providers offering the service you are looking for, please search the provider directory located on the website or call member services for more information.

Covered Services – Adults (Ages 18 and over)

Category	Service	Is Prior Authorization Required?	How Do I Access the Service?
Emergency Services
Crisis Intervention	Crisis Walk-In	No	If you are in need of emergency services, you can call 911 or go directly to a Crisis Response Center or Emergency Room.
Urgent Services
Inpatient Services	23-Hour Observation Acute Inpatient Psychiatric Hospitalization Subacute Inpatient Psychiatric Hospitalization Extended Acute Care	Yes Yes Yes Yes	If you believe you need treatment in an inpatient unit, you will need to go to an Emergency Room or Crisis Response Center for assessment. If you are seeking substance use services, you can also go to a Substance Use Assessment Center.
	Drug & Alcohol Medically Monitored Detoxification Inpatient Drug and Alcohol Medically Managed Detoxification Inpatient Drug and Alcohol Medically Managed Rehabilitation	Yes Yes Yes
Crisis Intervention	Crisis Residence	Yes
Non-Urgent Services
Mental Health Outpatient Treatment	Mental Health Outpatient Services Community Integrated Recovery Centers Mobile Psychiatric Rehabilitation Services Mental Health Partial Hospitalization Clozapine Psychological Testing Electroconvulsive Therapy	No No Yes Yes No Yes No	Search the provider directory on our website or call member services to find an outpatient provider. The provider will assist you with access to these services.
Drug & Alcohol Outpatient Treatment	Drug & Alcohol Outpatient Services Intensive Outpatient Program Drug & Alcohol Partial Hospitalization Medication Assisted Treatment (MAT)	No No No No
Case Management Services & Peer Support	Intensive Case Management Blended Case Management Resource Coordination Drug & Alcohol Targeted Case Management Assertive Community Treatment (ACT) Certified Peer Specialist	Yes Yes Yes Yes Yes Yes	For more information and how to access Targeted Case Management and Assertive Community Treatment services contact the Targeted Case Management Unit at (215) 599-2150.
Residential Rehabilitation Services for Drug & Alcohol Dependence / Addiction	Drug & Alcohol Halfway House Drug & Alcohol Medically Monitored Residential, Short-Term Drug & Alcohol Medically Monitored Residential, Long Term	Yes No Yes	If you believe you need treatment in a residential rehabilitation setting, you will need to go to an Emergency Room or Crisis Response Center for assessment.    If you are seeking substance use services, you can also go to a Substance Use Assessment Center.
Residential Treatment Facilities for Adults (RTFA)	Residential Treatment Facilities for Adults	Yes	If you believe you need treatment in an RTFA, you must be connected to a current provider who will provide a psychiatric evaluation. If you do not have an existing provider, contact member services to be connected.

Covered Services - Children and Adolescents – up to age 18 (up to age 21 for BHRS)

Category	Service	Is Prior Authorization Required?	How Do I Access the Service?
Emergency Services
Crisis Intervention	Crisis Intervention Walk-In Children’s Mobile Crisis Team	No No	If your child has a non-life-threatening emergency and needs mobile services, call the Mental Health Delegate Line at (215) 685-6440. You can also call 911 or go directly to a Crisis Response Center or Emergency Room.
Urgent Services
Residential Rehabilitation Services for Drug & Alcohol Dependence / Addiction	Adolescent Drug and Alcohol Residential Rehabilitation	Yes	If you believe you need treatment in an inpatient unit, you will need to be assessed at an Emergency Room or Crisis Response Center.
Inpatient Services	Acute Inpatient Psychiatric Hospitalization	Yes
Crisis Intervention	Children’s Mobile Intervention Services (CMIS) Crisis Stabilization Unit	No Yes	If you believe you need treatment from Children’s Mobile Intervention Services, you will need to be assessed at an Emergency Room or Crisis Response Center or by a Children’s Crisis Mobile Team.
Non-Urgent Services
Mental Health Outpatient Treatment	Mental Health Outpatient Services Acute Partial Hospital Program Psychological Testing	No Yes Yes	Search the provider directory on our website or call member services to find an outpatient provider. The provider will assist you with access to these services.
Drug & Alcohol Outpatient Treatment	Drug & Alcohol Outpatient Services Drug & Alcohol Intensive Outpatient Program	No No	Search the provider directory on our website or call member services to find an outpatient provider. The provider will assist you with access to these services.
Case Management Services	Blended Case Management Enhanced Case Management	Yes Yes	For more information and how to access Case Management services contact the Targeted Case Management Unit at (215) 599-2150.
Behavioral Health Rehabilitative Services (BHRS) for Members Under 21	Mobile Therapy (MT) Behavioral Specialist Consultant (BSC) Behavior Specialist for Children with Autism (BSC/ASD) Therapeutic Support Staff (TSS) School Therapeutic Services (STS) Applied Behavioral Analysis (ABA) Early Childhood Treatment Programs Summer Therapeutic Activities Program (STAP) Clinical Transition and Stabilization Services (CTSS)	Yes Yes Yes Yes Yes Yes Yes Yes Yes	Search the provider directory on our website or call member services to find an outpatient provider. The provider will assist you with scheduling an evaluation which is required to access these services.
Family Based Services	Family Based Services Functional Family Therapy Multi-systemic Therapy for Problem Sexual Behaviors (MST-PSB)	Yes Yes Yes
Residential Treatment Facilities (RTF)	Residential Treatment Facility (JCAHO and Non-JCAHO certified)	Yes
CRR Host Home	CRR Host Home	Yes