All Behavioral Health services are authorized based on Medical Necessity Criteria that is established by the Department of Public Welfare and Office of Mental Health and Substance Abuse Services.

The following are the links to the Medical Necessity Criteria that apply to the various levels of care offered through the HealthChoices Program:

Appendix T Part A1 - Adult Mental Health Medical Necessity Criteria (Acute Inpatient Hospitalization, Psychiatric Partial Hospitalization, and Psychiatric Outpatient Clinic)

Appendix T Part A2 - Adult Mental Health Service Necessity Criteria (Targeted Case Management)

Appendix T Part B1 - Child Mental Health Medical Necessity Criteria (Acute Inpatient Hospitalization, Residential Treatment, Psychiatric Partial Hospitalization, and Psychiatric Outpatient Clinic)

Appendix T Part B2 - Child Mental Health Medical Necessity Criteria - EPSDT (Behavioral Health Rehabilitation Services)

Appendix T Part B3 - Child Mental Health Medical Necessity Criteria - MHSP (Family Based Services)

Appendix T Part B4 - Child Mental Health Service Necessity Criteria (Targeted Case Management)

Appendix T Part C - Adult Client Placement Criteria (Drug & Alcohol related Services)

Appendix T Part D - Adolescent Placement Criteria (Drug & Alcohol related Services)