Behavioral and Primary Healthcare Coordination Program
Behavioral & Primary Healthcare Coordination Program
Indiana Medicaid offers coverage for Behavioral & Primary Healthcare Coordination (BPHC) of 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 both 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 Division of Mental Health and Addiction (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
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.
To apply for BPHC services, go to your local community mental health center.
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 email BPHCservices@fssa.in.gov.
BPHC services may be delivered by providers meeting specific state-defined criteria. DMHA certifies agencies to provide BPHC services. DMHA-certified community mental health centers are the exclusive providers of BPHC services.
DMHA-approved providers must also be enrolled with IHCP as a mental health care provider with the BPHC specialty. Refer to the Become a Provider webpage for more information.
Additional provider resources regarding BPHC services are available at the following links:
DMHA BPHC Services webpage
DMHA Behavioral and Primary Healthcare Coordination Services provider reference module
Home- and Community-Based Services Billing Guidelines provider reference module