Medical Necessity Criteria
Our medical necessity criteria (MNC), also known as clinical criteria, determine
medical/clinical necessity and appropriate level of behavioral health
care for individuals who receive services through MBHP programs.
The goal of these criteria is to promote recovery from the symptoms of
mental illness and substance use disorders and to support the Member's
stabilization at the highest level of functioning.
Our medical necessity criteria are reviewed and updated at least annually to ensure they reflect the latest developments
in serving individuals with behavioral health diagnoses.
Medical necessity criteria are a component of the MBHP Provider Manual, which is
an extension of the Provider Agreement with MBHP.
**Please note:
MBHP utilizes Change Healthcare’s InterQual Behavioral Health Medical Necessity Criteria for mental health levels of care;
unless otherwise noted, MBHP custom criteria should be used.
MNC with a globe icon are linked to an outside web page,
where providers can register and access those specific MNC through
InterQual. On that web page, click the "Registration" tab to get
started. For more information on InterQual MNC, please refer to Beacon/MBHP Broadcast 9.
MBHP also uses American Society of Addiction Medicine (ASAM) Criteria which focuses on substance use disorder treatment. Unless custom substance use disorder
criteria exists, ASAM criteria is the criteria for substance use disorder treatment.
For information about the ASAM criteria, see
An Introduction to the ASAM Criteria for Patients and Families. (Copyright 2015 by the American Society of Addiction Medicine. Reprinted with permission.
No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM.)
Inpatient Services
Inpatient services are provided in a 24-hour hospital setting and offer
evaluation and treatment of acute mental health or substance use
disorders.
Inpatient Mental Health Services >
Inpatient Mental Health Services for Persons with Developmental Disabilities or Autism
Spectrum Disorder

Inpatient High-Intensity Services
Inpatient Eating Disorder Services
Inpatient Substance Use Disorder Services (Level 4 Medically Managed Intensive Inpatient Withdrawal Management) - see ASAM Criteria
24-Hour Crisis Observation
Diversionary Services
Diversionary services are mental health and substance use disorder services that
provide intensive support upon returning to the community after a
Member has been in a hospital. These services can be provided in
a 24-hour facility or in a non-24-hour setting.
24-Hour Diversionary Services
Medically Monitored Inpatient Withdrawal Management – Level 3.7 (Adult/Adolescent Criteria) - see ASAM Criteria
Community-Based Acute Treatment Services (CBAT)
Community-Based Acute Treatment Services for
Children and Adolescents with Autism Spectrum Disorder/Intellectual Disabilities (CBAT ASD/ID)
Individualized Treatment and Stabilization Services (ITS) - see ASAM Criteria Levels 3.7 and 3.5
Youth and Transition-Age Youth Detoxification and Stabilization Services - see ASAM Criteria levels 3.7 and 3.5
Intensive Community-Based Acute Treatment Services (ICBAT)
Clinical Support Services (CSS) for Substance Use Disorders - see ASAM Criteria
Enhanced Acute Treatment (E-ATS)
Residential Rehabilitation Services (RRS) - see ASAM Criteria
Co-Occuring Enhanced RRS
Transitional Care Unit (TCU)
Non-24-Hour Diversionary Services Community Support Program (CSP)
Community Support Program for Individuals with Justice Involvement (CSP-JI)
Community Support Program for Homeless Individuals (CSP-HI)
Community Support Program Tenancy Preservation Program (CSP-TPP)
Intensive Outpatient Program (IOP) >
Partial Hospitalization Program (PHP) >
Program of Assertive Community Treatment (PACT)
Psychiatric Day Treatment >
Structured Outpatient Addiction Program (SOAP) - see ASAM Criteria
Outpatient ServicesOutpatient
mental health services are provided in places like clinics, community
health centers, hospital outpatient departments, the Member's home,
school, or other places in the community. These services, which
include individual therapy, group therapy, and family/couples therapy,
help with a variety of mental health issues such as trauma, depression,
anxiety, eating disorders, and adjustment disorders. Outpatient
substance use disorder services help with withdrawal from
substances. These services also support recovery from addiction.
Applied Behavior Analysis (ABA)
Acupuncture Treatment for Withdrawal Management - see ASAM Criteria
Ambulatory Withdrawal Management - see ASAM Criteria
Assessment for Safe and Appropriate Placement (ASAP)
Dialectical Behavioral Therapy (DBT)
Early Intensive Behavioral Intervention (EIBI)
Outpatient Professional Services >
Opioid Treatment Program (OTP) - see ASAM Criteria
Psych Consultation on Inpatient Medical Unit-ED
Psychological Testing >
Recovery Coach (RC)
Recovery Support Navigator (RSN)
Repetitive Transcranial Magnetic Stimulation (rTMS) >
Other Outpatient Services
Electroconvulsive Therapy (ECT) >
Community Behavioral Health Center (CBHC)
CBHC services are available 24 hours a day, 7 days a week, 365 days a year to anyone who is experiencing a mental health crisis. These services help reduce the immediate risk of danger to oneself or others.
Community Behavioral Health Centers (CBHCs) and Mobile Crisis Intervention (MCI), available for both youth and adults, are provided within community-based locations.
Adult Mobile Crisis Intervention (AMCI)
Youth Mobile Crisis Intervention (YMCI)
Community Crisis Stabilization (ACCS/YCCS)
Certified Peer Specialis (CPS)
Behavioral Health Services for Children and Adolescents (BHCA)
Commercial Members Only
Behavioral Health Services for Children and Adolescents (BHCA), implemented by the Division of Insurance (DOI), is an effort to strengthen, expand, and integrate community-based services
for the stabilization and support of families and their children with significant behavioral, emotional, and mental health needs.
Intensive Care Coordination (ICC)
Family Support and Training - Family Partner (FS&T-FP)
In-Home Behavioral Services (IHBS)
Therapeutic Mentoring (TM)
Children's Behavioral Health Initiative (CBHI) ServicesThe
Children's Behavioral Health Initiative (CBHI) is an interagency effort
of the Commonwealth's Executive Office of Health and Human Services
(EOHHS). Its mission is to strengthen, expand, and integrate
Massachusetts state services into a comprehensive, community-based
system of care to ensure that families and their children with
significant behavioral, emotional, and mental health needs obtain the
services necessary for success in home, school, and community.
Visit the CBHI Medical Necessity Criteria page >
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