Reminder to Bill Local RBHA for Initial Crisis Services
Date: 02/08/21
Regional Behavioral Health Authorities (RBHAs) are responsible for covering the first 24 hours of crisis services for Title XIX/XXI members and up to 72 hours for Non-Title XIX/XXI members. Providers should submit claims for these services to the RBHA in their Geographical Service Area (GSA).
Crisis services provided after the first 24 hours for Title XIX/XXI members should be billed to the member’s Arizona Health Care Cost Containment System (AHCCCS) Complete Care (ACC) Plan of enrollment.
Q: What are the RBHAs for each GSA?
A: The RBHA geographic service areas (GSA) remain the same today as they were on October 1, 2018, and are different than the AHCCCS Complete Care Plan (ACC) GSAs or the statewide American Indian Health Plan (AIHP).
- Central GSA: Mercy Care RBHA (formerly known as Mercy Maricopa Integrated Care – MMIC)
- Northern GSA, including Gila County: Health Choice Arizona RBHA (formerly known as Health Choice Integrated Care – HCIC)
- Southern GSA, including Pinal County: Arizona Complete Health-Complete Care Plan RBHA (formerly known as Cenpatico Integrated Care - CIC)
Q: What are considered crisis services?
A: AHCCCS understands that crisis services may vary based on the provider, setting, and GSA. These services include, but are not limited to:
Service | Population | Setting | Codes | Responsible Party |
|---|---|---|---|---|
Crisis services within first 24 hours | Medicaid, KidsCare and State Only | All providers/setting s permitted to bill these codes except observation crisis stabilization units | H2011, S9484, S9485 | RBHA |
Crisis services within first 24 hours | Medicaid, KidsCare and State Only | Observation crisis stabilization units | S9484, S9485, H0031, H0038, 90791, T1002, T1016 | RBHA |
Crisis phones | Medicaid, KidsCare and State Only | Telephonic | (T1016) Replaced with H0030 effective 7/1/20 | RBHA |
Assessments | Medicaid, | Emergency Department (ED)/Medical Floor | H0031, 90791, 90792 | Plan of |
ED visits | Medicaid, | ED | 99281 -99285 (Not considered “crisis services”) | Plan of |
ED visits | State Only | ED | 99281 -99285 (Are considered “crisis services”) | RBHA |
Assessments for pre- petition screening (for consideration for COE referral) | Medicaid, KidsCare and State Only | All |
| County or designation |
Serious Mental Illness (SMI) assessments for SMI determination | Medicaid, | All |
| Plan of |
SMI assessments for SMI determination | State Only | All |
| RBHA |
ADDITIONAL INFORMATION
If you have questions regarding the information contained in this update or need your assigned Provider Engagement Specialist contact information please email: AzchProviderEngagement@azcompletehealth.com.