Open Network

CBH is seeking Independent Practitioners and Group Practices for the Philadelphia Medicaid population.

What are Independent Practitioners and Group Practices?

• An Independent Practitioner is a clinician who provides behavioral health care services and bills under their own Taxpayer Identification Number (TIN).
• A Group Practice employs multiple physicians or other licensed professionals who are individually enrolled in PROMISe™ but bill under the Group’s TIN. Group Practices under Pennsylvania Medicaid are restricted to a single licensing body (all group participants are solely psychologists, LCSWs, etc.) and do not allow different licensed professionals to be enrolled in the same group practice.

The following licensed professionals are qualified to apply:

• Certified Registered Nurse Practitioner (CRNP)
• Marriage and Family Therapist (LMFT)
• Professional Counselor (LPC)
• Psychologist
• Psychiatrist
• Social Worker (LSW)
• Social Worker (LCSW)

What qualifications are necessary for each specialty?

• CRNPs must be certified in Psychiatry/Mental Health.
• Physicians must have completed, at a minimum, a psychiatry residency.
• LSWs must have completed a clinical practicum or internship as part of their master’s program.
• CBH only accepts providers with a physical brick-and-mortar service location. Providers are eligible to provide telehealth but must offer members the option to receive services in the treatment setting.
• CBH only accepts Independent Practitioners/Group Practices within 45 miles of Philadelphia County.

Apply as Independent Practitioners or Group Practices

CBH is seeking Applied Behavior Analysis (ABA) providers for the Philadelphia Medicaid population. CBH is currently not contracting for IBHS-ABA providers to deliver one-to-one site-based services.

What is Applied Behavior Analysis (ABA)?

ABA is a highly effective service delivered by Behavior Consultants (BC) and Behavioral Health Technicians (BHT) with specialized training and experience. ABA is considered the gold standard for supporting children with autism spectrum disorder (ASD) and other neurodevelopmental differences. ABA helps children learn new skills, such as communicating, interacting socially, and doing more things for themselves. ABA is also recommended to help decrease problem behaviors resulting from children having these skills deficits. All staff who provide ABA services are overseen by a Board-Certified Behavior Analyst (BCBA) at the provider agency.

The following licenses and conditions are needed to apply:

• If you are interested in obtaining an IBHS license, please contact the Office of Mental Health and Substance Abuse Services (OMHSAS) directly.
• To be considered, your facility must be enrolled in PROMISe™ under the program-specific provider type and specialty code. Providers not enrolled in PROMISe™ will have to reapply once their enrollment has been approved.
• CBH only accepts providers with a physical brick-and-mortar service location. Providers are eligible to provide telehealth but must offer members the option to receive services in the treatment setting.
• CBH only accepts providers with a service location in Philadelphia County.
• Please review CBH’s IBHS and ABA Clinical Performance Standards.

Apply as Intensive Behavioral Health Services – Applied Behavior Analysis (IBHS-ABA)

CBH is seeking Mental Health Outpatient Program (MHOP) providers for the Philadelphia Medicaid population.

What is a Mental Health Outpatient Program?

A Mental Health Outpatient Program (MHOP) is a nonresidential treatment setting licensed by the Office of Mental Health and Substance Abuse Services (OMHSAS). The outpatient program must offer psychiatric, psychological, social, educational, and other related services provided under medical supervision. It is designed for the evaluation and treatment of individuals with mental illness or emotional disturbance.

The following licenses and conditions are needed to apply:

• Your facility must comply with the 5200 regulations outlined by the Department of Human Services.
• Your agency must be a licensed MHOP. If you are interested in becoming a licensed MHOP clinic, please contact the Office of Mental Health and Substance Abuse Services (OMHSAS) directly.
• To be considered, your facility must be enrolled in PROMISe™ under the program-specific provider type and specialty code. Providers not enrolled in PROMISe™ will have to reapply once their enrollment has been approved.
• CBH only accepts providers with a physical brick-and-mortar service location. Providers are eligible to provide telehealth but must offer members the option to receive services in the treatment setting.
• CBH only accepts providers with a service location in Philadelphia County.

Apply as Mental Health Outpatient (MHOP)

CBH is seeking Psychiatric Residential Treatment Facilities (PRTF) providers for the Philadelphia Medicaid population.

What is a Psychiatric Residential Treatment Facilities (PRTF)?

PRTF is any non-hospital facility that provides inpatient service benefits to Medicaid-eligible individuals under the age of 21.

The following licenses and conditions are needed to apply:

• CBH recognizes the need for youth to have access to safe, in-community facilities to meet treatment needs while integrating family members and member voices throughout care for youth ages 6-18.
• PRTFs must demonstrate high competency in treating intense emotional and behavioral challenges, including aggression, histories of trauma, multiple placements, elopement, co-occurring developmental disabilities, and co-occurring addiction needs.
• If you are interested in obtaining a PRTF license, please contact the Office of Mental Health and Substance Abuse Services (OMHSAS) directly.
• To be considered, your facility must be enrolled in PROMISe™ under the program-specific provider type and specialty code. Providers not enrolled in PROMISe™ will have to reapply once their enrollment has been approved.
• CBH only accepts PRTF providers with a service location in or within 100 miles of Philadelphia County.

Apply as a Psychiatric Residential Treatment Facility (PRTF)

CBH is seeking Medically Managed Intensive Inpatient Services (ASAM 4) and Medically Managed Intensive Inpatient Services – Withdrawal Management (ASAM 4WM) providers for the Philadelphia Medicaid population.

What are Medically Managed Intensive Inpatient Services (ASAM 4)?

Medically Managed Intensive Inpatient Services (ASAM 4), derived from the American Society of Addiction Medicine (ASAM) Criteria, 3rd Edition, provides 24-hour inpatient treatment for individuals with substance use disorders (SUDs) who have acute emotional, behavioral, and cognitive concerns and require comprehensive medical and nursing care. While SUD treatment is the primary focus, the integration of additional support services addressing co-occurring biomedical conditions and mental health disorders is provided by an interdisciplinary team comprised of medical, addiction, and behavioral health professionals. In alignment with ASAM regulations, medical management by physicians, primary nursing care, and observation are provided 24 hours a day, and professional counseling services are provided 16 hours a day.

Individuals admitted to Medically Managed Intensive Inpatient Services receive a comprehensive nursing assessment and biopsychosocial evaluation at admission, a history and physical examination by a physician within 12 hours of admission, and a strengths-based treatment plan focusing on goals and progress monitoring. Individualized treatment may include cognitive, behavioral, motivational, pharmacological, and other therapies provided individually or in a group setting. In alignment with CBH’s policies, providers should have the capability to induct or provide maintenance of medication-assisted treatment (MAT). While the primary focus of treatment is stabilizing any acute signs and symptoms, simultaneous case management and coordination of care are provided to ensure a smooth transition to less restrictive treatment.

What are Medically Managed Intensive Inpatient Services – Withdrawal Management (ASAM 4WM)?

Medically Managed Intensive Inpatient Services – Withdrawal Management (ASAM 4WM), derived from the American Society of Addiction Medicine (ASAM) Criteria, 3rd Edition, provides treatment to individuals experiencing severe, unstable withdrawal and medical instability. Daily physician visits and 24-hour nursing care are provided in an acute care setting. The focus is on reducing acute emotional, behavioral, cognitive, and/or biomedical distress resulting from, or co-occurring with, the individual’s substance use.

Individuals admitted to Medically Managed Intensive Inpatient Withdrawal Management Services receive a comprehensive nursing assessment and biopsychosocial evaluation at the time of admission, a history and physical examination by a physician within 12 hours of admission, and a strengths-based treatment plan focusing on goals and progress monitoring. Daily clinical services include appropriate medical treatment, withdrawal support, and therapy. The scope of cognitive, behavioral, medical, mental health, and other therapies are administered individually or in a group setting. Much of the focus is on addiction education, understanding the withdrawal management process, and identifying the appropriate level of care for continued treatment. When withdrawal signs and symptoms are sufficiently resolved, and there is no longer a need for acute medical management, individuals can be transitioned to less intensive levels of care.

The following licenses and conditions are needed to apply:

• Your facility must be enrolled in PROMISe™ under the program-specific provider type and specialty code. Providers not enrolled in PROMISe™ will have to reapply once their enrollment has been approved.
• Your facility must be licensed by the Pennsylvania Department of Drug and Alcohol Programs (DDAP).
• CBH only accepts providers with a service location in Philadelphia County.

Apply as an ASAM 4.0 Medically Managed Intensive Inpatient Services Provider.