Date Issued: 5/17/2019
Starting July 1, 2019, EmblemHealth Enhanced Care will cover more behavioral health services for children and youth.
Medicaid members under age 21 will be able to access these services through their EmblemHealth Enhanced Care plan (some of these services may already be covered for certain eligible children under age 21):
- Office of Alcoholism and Substance Abuse Services (OASAS) Outpatient – Clinic (hospital based)
- OASAS Outpatient – Rehabilitation Programs (hospital based)
- OASAS Opioid Treatment Program Services (hospital based)
- OASAS Chemical Dependence Inpatient Rehabilitative Services
- Injections for Behavioral Health Related Conditions
- Children and Family Treatment and Support Services (CFTSS), including:
- Other Licensed Practitioner (OLP)
- Psychosocial Rehabilitation (PSR)
- Community Psychiatric Supports and Treatment (CPST)
- Family Peer Support Services
- Office of Mental Health (OMH) Outpatient Services
- OMH-designated Serious Emotional Disturbance (SED) Clinic Services
- Assertive Community Treatment (ACT)
- Continuing Day Treatment
- Personalized Recovery Oriented Services (PROS)
- Partial Hospitalization
- Psychiatric Services
- Psychological Services
- Comprehensive Psychiatric Emergency Program (CPEP) including Extended Observation Bed
- Inpatient Psychiatric Services
EmblemHealth Enhanced Care will cover these services for all eligible children and youth under age 21, including those:
- With Supplemental Security Income (SSI);
- Who have federal Social Security Disability Insurance (SSDI) status; or
- Who have been determined certified disabled by a New York State Medical Disability Review.
For help finding providers, call 888-447-2526. For Montefiore members, call
800-401-4822. You can also go to emblemhealth.com/Find-a-Doctor.
For more information, visit: health.ny.gov/health_care/medicaid/redesign/behavioral_health/children/index.htm.