Provider Manual
Last Update: December 4, 2025
Download the
CBH Provider Manual
Please Note: The document linked above now replaces all previous materials and links presented on this page. Do not bookmark the direct link to the PDF; instead, bookmark the link to this webpage.
Additional Manual-Related Documents and Forms
Many secondary attachments, once separate from the Manual, have been absorbed into different sections. Moving forward, all documents, guidelines, and forms referenced throughout the CBH Provider Manual will be housed and linkable below through this webpage.
Please Note: As of December 2025, all forms referenced in the CBH Provider Manual are primarily located on this webpage, under the tabs below.
Credentialing
Credentialing Documents
- Manual for Review of Provider Personnel Files (MRPPF)
Version 2.9 (Updated November 2025)
Related Forms
Authorizations
Authorizations Documents
- Medical Necessity Criteria (MNC) Webpage
- Utilization Review Care Coordination Grid
(Updated August 2025) - CBH Continua of Services
(Updated December 2025)
Related Forms
- CBH Authorization Correction Form (XLSX)
- Out-of-Network Provider Application
- Significant Incident Reporting Form
- IBHS Written Order (WO) Form (DOCX)
- Neuropsychological/Psychological Testing Prior Authorization Request Form
- DBHIDS Integrated Intake Application Packet
- Children’s Blended Case Management Referral Form
- Children’s Community-Based Services Referral Form (FBS)
- Children’s Community-Based Services FFT Referral Form
- Children’s Community-Based Services MST Referral Form
- Neuropsychological/Psychological Testing Prior Authorization Request Form
Quality
Program Integrity
Program Integrity Documents
- Program Integrity Department Audit Codes
(Updated August 2025) - Program Integrity Treatment Planning Guide
(Updated October 2025) - Program Integrity Clinical Documentation Requirements: Specific Levels of Care
(Updated August 2025) - IBHS Billing Guide
(Updated May 2023)
Related Forms
Finance
Finance Documents
- CBH 5010 Institutional Companion Guide
V1.12 (Updated November 2024) - CBH 5010 Professional Companion Guide
V1.9 (Updated November 2024) - CBH 5010 Health Care Claim Acknowledgement Companion Guide
V1.2 (Updated October 2022) - CBH 5010 Health Care Claim Payment/Advice Companion Guide
V1.1 (Updated October 2022) - CBH 5010 Trading Partner Companion Guide
V1.2 (Updated October 2022)
Related Forms
- Regular Claim Form (Sample with Required Fields)
- Lab Claim Form Required Fields (Sample with Required Fields)
- TPL Claim Form Required Fields (Sample with Required Fields)
- CBH Direct Deposit Agreement Form
- CBH Claims Adjustment Request Form
- CBH Third Party Liability (TPL) Discrepancy Form
- CBH Claims Electronic Appeals Process Form
Billing Resources
- CMS 2024 Updates to ICD-10 Codes
The diagnosis code lists are derived from ICD-10 diagnosis codes that CMS posts each year so that providers and suppliers utilize the applicable diagnosis codes when submitting medical claims to Medicare.- Additional information and downloads for the 2024 ICD-10-CM update
The ICD-10-CM April 1, 2024 update addresses typographical errors. No new diagnosis codes are being implemented. The files in the downloads section contain information on the ICD-10-CM updates effective with discharges on and after April 1, 2024.
- Additional information and downloads for the 2024 ICD-10-CM update
- U.S. HHS HIPAA Guidance Materials
Secure File Transfer
Secure File Transfer Related Forms
Clinical Practice Guidelines
Clinical Performance Standards
- Applied Behavior Analysis – Early Childhood Programs (ABA–EC)
December 2024 - Mobile Crisis Response Services
June 2024 - Acute Inpatient Psychiatric (AIP)
May 2024 - Opioid Centers of Excellence
December 2023 - Family-Based Mental Health Services
October 2023 - Federally Qualified Health Center (FQHC)
September 2023 - Behavioral Health Case Management
August 2023 - Acute Partial Hospital Program (APHP) – Child, Adolescent, and Adults
May 2023 - Tobacco Use Disorder
May 2023 - Crisis Response Center Services for Children and Adults
May 2023 - Psychiatric Residential Treatment Facility
May 2023 - Intensive Behavioral Health Services (IBHS)
May 2023 - Applied Behavior Analysis (ABA)
May 2021
CBH Screening Program Documents
- Provider Bulletin 25-17
(Issued April 28, 2025) - Provider Bulletin 25-26
(Issued August 1, 2025) - CBH HL7 Submission Guide
(Updated October 15, 2025) - HL7 HEDIS Measure Data Submission Training FAQ
(Posted August 29, 2025) - Screening Program Guides (Posted September 4, 2025)
Additional Documents
- CBH Acronym and Initialism Guide
(Updated December 2025) - Alcohol Use Disorder: A CBH Network Best Practices Guide
(Updated September 2023) - ASAM 3.7 Medically Monitored Intensive Inpatient Services Wound Care Reference Guide
(Updated May 2025) - Gaps in Care Guide
(Added October 2025) - Spravato® (Esketamine): Protocol and Procedures for Behavioral Health Provider Implementation of the Two-Hour Monitoring Period
(Updated October 2025) - Telehealth Best Practice Guidelines
(Updated November 2024)
