Prior Authorization update: Effective Immediately, Prior Authorization is Required for all Behavioral Health Community Support Services

Date: 10/09/20

Heritage Health (Medicaid):

Effective immediately, Nebraska Total Care, in required adherence to NAC 471 Chapter 35-004.01C, will require prior-authorization for all Community Support Services (Procedure Codes: H2015-HE and H2015-HF).

Authorization requests will be made for Community Support through the existing Behavioral Authorization methods as identified in the Provider Manual. Failure to obtain prior authorization for services will impact claim adjudication and denials. Members have all appeal rights available to them related to service authorization determinations.

Please share this information with the utilization management staff/department at your facility that is responsible for the authorization process with Nebraska Total Care so that they are aware of this new requirement.

If you have any questions, please contact BH Provider Relations.