Read this content carefully so you know what services are covered. If you still have questions about which services are covered or need more information about a covered service, contact CBH Member Services.
Emergency services are services needed to treat or evaluate an emergency medical condition, including a behavioral health condition. An emergency medical condition is a condition that is so severe that a reasonable person with no medical training would believe that there is an immediate risk to a person’s life or long-term health. If you have an emergency medical condition, go to the nearest emergency room, dial 911, or call your local ambulance provider. You do not have to get prior approval from CBH to get emergency services, and you may use any hospital or other setting for emergency care.
CBH covers outpatient services for behavioral health needs and substance use disorders. Outpatient services do not require an overnight stay at a hospital. CBH will help arrange for these services at one of our network providers.
Inpatient Hospital Services
CBH covers inpatient hospital services for behavioral health needs and substance use disorders. You must use a hospital in CBH’s network. To find out if a hospital is in CBH’s network, check our online Provider Directory.
If you are outside of the Philadelphia area and need emergency mental health or substance use services, call 911 or go to the closest hospital or clinic to receive emergency care. The emergency provider will contact CBH to ensure payment is arranged.
It is important to follow up with your doctor after you are discharged from the hospital. You should go to all your appointments after you leave the hospital. You will usually have a doctor’s appointment within seven days of your discharge from the hospital.
CBH does not pay for medication. Medications, including medications you take for your behavioral health, are covered by your Physical Health Managed Care Organization (PH-MCO). Please refer to your PH-MCO to find out which medications are covered.
Medication-Assisted Treatment (MAT) uses medications such as Methadone, Suboxone, or Vivitrol to treat opioid dependence. MAT is covered by CBH. Methadone, Suboxone, Vivitrol, and other medications used to treat opioid dependence are prescribed by CBH’s network providers and covered by your physical health plan. If you have any questions about MAT, you can contact CBH Member Services.
Some services may be provided to you through videoconferencing technology (you talk to your doctor or other provider on an electronic screen). This is called telehealth. The use of telehealth helps members receive hard-to-schedule services more quickly. If you are offered a service through telehealth, you will be given a choice between telehealth services or face-to-face services. The CBH network currently offers limited access to telehealth services.