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Behavioral and Primary Healthcare Coordination Program

Behavioral & Primary Healthcare Coordination (BPHC) Program

Indiana Medicaid offers coverage for Behavioral & Primary Healthcare Coordination (BPHC) home and community-based services (HCBS).  This service helps members manage their physical and behavioral health care needs through education, support, and advocacy.

Individuals must meet HCBS eligibility and Medicaid eligibility guidelines in order to be eligible for BPHC services.  To be eligible individuals must:

  • Be 19 years of age or older

  • Be eligible for Traditional Medicaid, HIP State Plan Plus, HIP State Plan Basic, or Hoosier Care Connect

  • Demonstrate a level of need by meeting the following criteria:

  • Receive a score of 3 or higher on the DMHA-approved assessment tool

  • Not be a danger to self or others

  • Be diagnosed with an BPHC-eligible primary mental health diagnosis

  • Have a documented treatment need specific to the management of behavioral and primary health care coordination that currently is or has the potential of impacting daily life

 

Covered Services

In addition to Medicaid-covered services, BPHC offers one service that consists of the coordination of health care services to manage the mental health/addiction and physical health care needs of eligible recipients.

Member Information

  • To apply, first, go to your local community mental health center (CMHC).

  • You must also apply for Medicaid.  You can learn more about applying for Medicaid by going to the Apply for Medicaid webpage.

  • For more information on BPHC please visit the BPHC webpage or contact BPHCservices@fssa.in.gov

Provider Information

  • Behavioral and Primary Healthcare Coordination (BPHC) services may be delivered by providers meeting specific State-defined criteria. The Family and Social Services Administration/Division of Mental Health and Addiction (FSSA/DMHA) certifies agencies to provide BPHC services. DMHA-certified community mental health centers (CMHCs) are the exclusive providers of BPHC services,

  • DMHA-approved providers must also be enrolled with IHCP as a mental health provider with the BPHC specialty (refer to the Become a Provider webpage).

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