This BHIN provides an update to the authorization requirements for Outpatient Specialty Mental Health Services (SMHS). The difference between this BHIN and the previous authorization BHIN (22-016) is a simple change to which services require prior authorization. IHBS is removed, no longer requiring authorization. The youth and adult EBPs are added, including the two that require prior authorization (ACT and FACT). An authorization code for IHBS was never created in SmartCare, as IHBS is governed by Special Populations rather than procedure codes. BH Connect authorization codes should be created as needed as part of BH Connect implementation.
The process of requesting authorization has not changed. Counties should continue to use the existing authorization request method they are currently using. No changes will be made to SmartCare in response to this BHIN. Counties may use the Service Request process, the old Authorization Tracking document, or the authorization request process in Connex. Minor adjustments will be made to the services in Connex to align with the services requiring prior authorization in the BHIN.
Regarding alignment with BHIN 26-008, this BHIN has no impact to CalMHSA’s current interoperability plan.