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Medicaid Rehabilitation Option (MRO)

Services for the Indiana Health Coverage Programs (IHCP) Medicaid Rehabilitation Option (MRO) include community-based behavioral healthcare for individuals with serious mental illness (SMI), youth with serious emotional disturbance (SED) and/or individuals with substance use disorders (SUDs). MRO services are clinical behavioral health services provided to members and families of members living in the community who need aid intermittently for emotional disturbances, mental illness and addiction.

MRO services must be provided by an IHCP-enrolled community mental health center (CMHC). Each MRO service must be rendered by an appropriate practitioner, as described in the Medicaid Rehabilitation Option Services provider reference module. Allowable MRO practitioners fall into three main categories:

  • Licensed professional
  • Qualified behavioral health professional (QBHP)
  • Other behavioral health professional (OBHP)

IHCP reimbursement for MRO services is available for members who meet specific diagnosis and level-of-need (LON) criteria under the approved Division of Mental Health and Addiction (DMHA) assessment tool – Adult Needs and Strengths Assessment (ANSA) or Child and Adolescent Needs and Strengths (CANS). Members who have a qualifying MRO diagnosis are assigned a service package based on their individual LON. For the majority of members receiving MRO services, the assigned MRO service packages provide a sufficient number of services and units of services to meet their needs. However, for members who require additional medically necessary MRO services not included in the service package, or additional units of services assigned in the service package, a prior authorization (PA) request is required. MRO services are carved out of managed care and reimbursed as fee-for-service (FFS) for all eligible members.

MRO services are designed to assist in the rehabilitation of the member's optimum functional ability in activities of daily living (ADLs) by:

  • Assessing the member's needs and strengths
  • Developing an Individualized Integrated Care Plan (IICP) that outlines objectives of care, including how MRO services assist in reaching the member's rehabilitative and recovery goals
  • Delivering appropriate services to the member

More Information

For step-by-step information about verifying eligibility, and checking and updating PA requests for MRO services, see the Quick Reference Guide: Provider Healthcare Portal: Medicaid Rehabilitation Option (MRO). Additional information is also available in the Medicaid Rehabilitation Option Services provider reference module.

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