Missouri Care Behavioral Health Care
Missouri Care will cover your behavioral health needs. A primary care provider (PCP) referral is not needed for behavioral health care. You may go to any behavioral health provider on Missouri Care’s list of providers. You can get four visits in a year without asking us first. Be sure to go to a behavioral health provider in our network. You can find a provider by clicking on Find a Provider. Behavioral health care includes care for people who abuse drugs or alcohol or need other behavioral health services. Call Missouri Care Behavioral Health at 1-800-889-4073
to get behavioral health services.
Missouri Care now offers our members a 24-hour behavioral health crisis line because sometime you can’t wait to get an answer. The number to call is 1-866-545-0042.
We are here for you.
Children who are in Alternative Care or get Adoption Subsidy get behavioral health care through MO HealthNet Fee-for-Service using MO HealthNet approved providers. These children only get their physical health care from Missouri Care.
Missouri Care Behavioral Health Care
The table below shows the basic behavioral health benefits available to Missouri Care members. The table is not an exhaustive list. The specific services to be delivered to Missouri Care Members are described in detail in the MO HealthNet Managed Care Policy Statement. If you have questions as to whether a service is covered, contact the Missouri Care Behavioral Health Department at 1-800-889-4073.
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Covered Behavioral
Health Service Overview
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Covered
Service
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Service
Description
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Outpatient
Counseling
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Counseling
with member, family members and/or group members; includes physician services as
medically necessary; provided in an office setting from 60 to 90 minutes
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Inpatient
Treatment
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Acute
inpatient, 24-hour, medically-based behavioral health treatment in either a specialty
or general hospital setting. Includes detoxification.
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Detoxification
Services
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Detoxification
from acute phase of alcohol and drug abuse.
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Court-Ordered
Services
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Services
in the Comprehensive Benefit Package that are court-ordered for involuntary care
and meet medical necessity criteria.
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Emergency
and Crisis Intervention
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Crisis/emergency
face-to-face contact available 24 hours, seven days per week.
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Medication
Monitoring
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Medication
monitoring and management. Individualized case management is provided and reported,
but is not counted against the basic mental health benefit limit.
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Case Management
Case management assists participating providers in the care of members with special needs or complex behavioral health problems. Case management is available plan-wide. The following types of cases are most commonly referred to mental health case management:
- Pregnant and substance abusing members with treatment compliance
and relapse problems
- Two or more readmissions within three months
- Chronic lethality risk with history of suicide attempts
- Chaotic family contributing to high use of service/cost
of service
- Dual-diagnosed (substance abuse and behavioral health)
members with more than two admissions in a three-month period and treatment compliance
problems
- Children and adolescents at risk of out-of-home placement
or loss of parental custody as indicated by either prior, current, or record of
considerations of out of home placement or removal of parental custody
Behavioral Health Services Limitations
Missouri Care will cover your behavioral health needs. A PCP referral is not needed for behavioral health care. You may go to any behavioral health provider on Missouri Care’s list of providers. You may get four visits in a year without our okay. Be sure to go to a behavioral health provider in our network. Behavioral health care includes care for people who abuse drugs or alcohol or need other behavioral health services. Call Missouri Care at 1-800-322-6027 or Missouri Care
Behavioral Health at 1-800-889-4073 to get behavioral health services.
Children, who are in Alternative Care or get Adoption Subsidy, get behavioral health care through MO HealthNet Fee-for-Service using MO HealthNet approved providers. These children get their physical health care from Missouri Care.