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Transmittal #21-23 Managed Care Program Authorization Guidance for SUD Residential Treatment Services

Friday, June 11, 2021

This guidance provides direction to SUD residential treatment providers to assess beneficiaries (aged 21-64) for IMD stays, obtain an authorization from the appropriate payer, and bill the
appropriate health plan utilizing the “In Lieu of” benefit under the Managed Care plans or Fee for Service (FFS) when the “In Lieu of” benefit is exceeded.