We work with the State of Kansas to provide mental health and substance abuse services for you and your children. We want you and your children to feel good about yourselves and be healthy.
Cenpatico covers a full range of treatment. Covered services for Cenpatico members include services such as:
|Covered Service|| Service Description
(A Cenpatico network provider must provide all medically necessary services)
|Limits and Rules|
|Diagnostic Services||An evaluation to determine your mental health or substance abuse treatment needs.||No prior authorization required for an evaluation conducted every 6 months|
||No prior authorization required for emergency services|
|Acute Inpatient Hospital Services||This is services in an acute psychiatric hospital||Prior authorization required|
|Day Treatment – Partial Hospitalization Program (PHP)||Day Treatment/PHP is a short-term program that provides support and treatment. It includes coordinated, intensive treatment that is more intense than outpatient care. The structured format provides medical monitoring, plus therapeutic groups and activities.||Prior authorization requiredMembers using this service return home in the eveningMembers may attend daily sessions, 6 to 8 hours in length, Monday through Friday|
|Residential Treatment Services/PRTF||Services for mental health and substance abuse treatment includes:
provided in a residential treatment facility where the member temporarily stays overnight.
|Prior authorization required|
|Intensive Outpatient Program (IOP)||The Intensive Outpatient Program is very structured and includes some combination of individual, group, and family counseling. Counseling and education may be for substance abuse-related disorders or mental health.||Prior authorization requiredMembers may attend sessions of 3 hours a day at least 3 times a week|
|Outpatient Services||Individual, family or group therapy, usually offered in an office but sometimes in the home or other setting. Includes services to evaluate and treat mental health and substance abuse.||No prior authorization required for initial evaluation and five (5) visitsPrior authorization required after initial evaluation and visits|
|Psychological Testing||Testing to more clearly determine diagnoses and status||Prior authorization requiredNote: IQ testing or testing to determine if a person has learning disabilities is not covered|
|Medication Management||Prescription and medication monitoring for the treatment of a behavioral health condition or disorder||No authorization required for outpatient visits to a participating doctor, nurse practitioner, or physician’s assistant|
|Home-based Family Therapy||
||Prior authorization required|
|Family Education and Support Services||Services include information about the member’s disorder, information and training in managing the member’s disorder, and training in supporting the member in staying healthy||The member or responsible party must agree that the member’s information may be released to the family members|
*Please refer to your member handbook for a full list of covered and non-covered services.