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CBHI Services Information for Providers

This section contains Performance Specifications, Medical Necessity Criteria and other important information on CBHI services that providers need.

Table of Contents

Performance Specifications

Performance Specifications lay out the requirements to which all MassHealth Providers contracted for a service or level or care are expected to comply. 

Link to Performance Specifications here.

Medical Necessity Criteria

MassHealth providers who have contracted for a service use medical necessity criteria established by MassHealth to evaluate whether a member has a medical need for a service.

Link to Medical Necessity Criteria here.

Practice Guidelines

Practice Guidelines support the alignment of MassHealth home- and community-based services with the values that are important to families, support positive outcomes, and reflect the best intentions and expectations of CBHI. The Guidelines reference professional standards, recommended practices, required service components, and quality measures consistent with Wraparound principles.

Link to Practice Guidelines here.

CBHI-State Agency Protocols

CBHI collaborated with Executive Office of Health and Human Services agencies to develop referral protocols for accessing MassHealth's behavioral health services for state agency staff. The following protocols are available.

Link to CBHI State Agency Protocols here.

Evaluation of Need for Intensive Care Coordination (ICC)

Families with children younger than 21 in outpatient services should be reevaluated periodically on their need for ICC. To make sure this happens, all MCEs require documentation within 30 days of a client’s first visit and every six months thereafter using this form if the youth has SED. PDF | Word

System of Care Tip Sheet: Caring Together and CBHI

CBHI and the Departments of Children and Families (DCF) and Mental Health (DMH) created this Tip Sheet for providers to describe the interface, coordination, and transition between CBHI/MassHealth services and Caring Together Services. PDF | Word

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