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Enhanced Community Based Behavioral Health Services Request Form

Posted October 15, 2019

Blue Cross Community Health PlansSM (BCCHPSM) and Blue Cross Community MMAI (Medicare-Medicaid Plan)SM are introducing an enhanced authorization request form for Assertive Community Treatment, Community Support Team and Psychosocial Rehabilitation. All Medicaid requests for authorization of these services should be completed through submission of the new Community Based Behavioral Health Services Request Form (formerly titled Rule 132 Authorization) which is available on our Provider website. Thank you for your cooperation as we work to optimize the authorization process to better serve our providers and members.