'Ohana Health Plan provides behavioral health benefits to members enrolled in our Medicaid plans. We are committed to quality service and partnership with providers to ensure members get the most of their benefits.
In the event of a crisis, please direct members to the Department of Health access line at 1-800-753-6879.
The plan offers additional behavioral health care management services for qualifying adults with a diagnosis of serious persistent mental illness.
Behavioral health services requiring prior authorization include:
- Acute inpatient
- Partial hospitalization program
- Intensive outpatient program
- ECT treatment
- Psychological testing
Behavioral health services that do NOT require prior authorization:
- Psychiatric or psychological evaluations
- Physician services including medication management
- Some outpatient counseling and therapy (Reference the Behavioral Health Authorization List below for code details)
- Methadone treatment services
- Behavioral Health Authorization List - English (PDF)
- Revenue/Procedure Code Service Group Matrix - English (PDF)
- Provider METS Flyer (Members Empowered To Succeed) - English (PDF)
- 2021 Behavioral Health Bonus Program Announcement - English (PDF)
- Quick Reference Guide - English (PDF)
- Coordination of Care Tip Sheet - English (PDF)
- Titration Services Tip Sheet - English (PDF)
- Discharge Readiness Tip Sheet - English (PDF)
- Treatment Plan Development Tip Sheet - English (PDF)
Other Helpful Information
Behavioral Health Forms
Find forms for authorizations, referrals and more.
Community Care Services
Adult Medicaid members age 21 years or older with a diagnosis of serious mental illness (SMI) or a severe and persistent mental illness (SPMI) may be eligible for additional behavioral health services from the Community Care Services (CCS) program offered by 'Ohana Health Plan.