On July 1, 2019, all Substance Use Disorder (SUD) Waiver services, except for Opioid Treatment Programs (Methadone), will be covered by Medicaid Managed Care Organizations (MCOs) for their members. SUD providers will receive prior authorizations for services from and submit billing for services to the MCOs for members enrolled within their health plan. All SUD providers should prepare for this upcoming transition by ensuring they are enrolled and credentialed with the MCOs below:
MCO Claims and Authorizations:
Aetna - 1-888-348-2922 or 1-888-348-2922
The Health Plan - 1-888-613-8385 1-877-847-7901
UniCare - 1-800-782-0095 or 1-800-782-0085
SUD providers for Medicaid members who are not enrolled in an MCO will continue to submit request for authorizations and claims through the fee-for-service program.
Fee-For-Service Claims and Authorizations:
1-888-483-0797 or 1-888-483-0793
Click here to access Chapter 504, Substance Use Disorder Services (the SUD Waiver Manual)
For authorizations that are approved beyond June 30, 2019 from KEPRO, providers will be required to submit claims for dates of service prior to July 1st to DXC. Services from July 1st and beyond will be required to be submitted to the member's MCO.