{"id":8766,"date":"2025-09-04T18:26:51","date_gmt":"2025-09-04T18:26:51","guid":{"rendered":"https:\/\/hnetalk.com\/provider\/?p=8766"},"modified":"2025-09-04T18:26:51","modified_gmt":"2025-09-04T18:26:51","slug":"behavioral-health-policy-updates-september-2025","status":"publish","type":"post","link":"http:\/\/hnetalk.com\/provider\/behavioral-health-policy-updates-september-2025\/","title":{"rendered":"Behavioral Health Policy Updates (September 2025)"},"content":{"rendered":"

Please read the following update related to various Health New England programs and changes that may have an impact on your patients and\/or your practice.<\/span><\/p>\n

If you have any questions about the information in this notice, please contact Health New England Provider Experience at (800) 842-4464, extension 5000. A representative is available Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m.<\/p>\n

 <\/p>\n\n\n\n\n\n
Behavioral Health Policy –\u00a0 New<\/span><\/i><\/b><\/td>\nEffective Date<\/span><\/i><\/b>\u00a0<\/span><\/td>\nSummary of Changes<\/span><\/i><\/b>\u00a0<\/span><\/td>\n<\/tr>\n
Intensive Outpatient Program (IOP); Partial Hospitalization Program (PHP)<\/td>\n\u00a08\/14\/2025<\/span><\/b>\u00a0<\/span><\/td>\n\n
    \n
  • Documents process already in place.<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
Applied Behavioral Analysis for Down Syndrome<\/td>\n1\/1\/2026<\/span><\/b>\u00a0<\/span><\/td>\n\n
    \n
  • Applies to Commercial and Self-Funded plans who have accepted the DOI requirements.<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

     <\/p>\n\n\n\n\n\n\n\n\n\n
    Behavioral Health Policy – Annual<\/span><\/i><\/b><\/td>\nEffective Date<\/span><\/i><\/b>\u00a0<\/span><\/td>\nSummary of Changes<\/span><\/i><\/b>\u00a0<\/span><\/td>\n<\/tr>\n
    Applied Behavioral Analysis for Autism Spectrum Disorder<\/td>\n\u00a09\/1\/2025<\/span><\/b>\u00a0<\/span><\/td>\n\n
      \n
    • Removed the following language: A minimum of one (1) hour treatment planning per month is required, up to one (1) hour for every 10 hours of direct service.<\/li>\n
    • Removed from Prior Authorization section 11, A, 1: language related to the FBA for ASD.<\/li>\n
    • Separated the PARF for ABA FBA and ABA services requirement.<\/li>\n
    • Added language on requirements for ABA FBA testing tools.<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
    Admission and Concurrent Review Criteria for ASAM 3.5<\/td>\n10\/1\/2025<\/span><\/b>\u00a0<\/span><\/td>\n\n
      \n
    • No changes<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
    Inpatient Rehabilitation (ASAM Level 3.7) for Substance Abuse <\/span><\/td>\n10\/1\/2025<\/span><\/b>\u00a0<\/span><\/td>\n\n
      \n
    • No changes<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
    Clinical Review Criteria Related to Community-Based Acute Treatment\/Youth Clinical Crisis Stabilization (CBAT\/YCCS) Program and Intensive Community-Based Acute Treatment (ICBAT) Program<\/td>\n10\/1\/2025<\/span><\/b>\u00a0<\/span><\/td>\n\n
      \n
    • No changes<\/span><\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
    Behavioral Health Day Treatment<\/td>\n10\/1\/2025<\/span><\/b>\u00a0<\/span><\/td>\n\n
      \n
    • No changes<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
    Neuropsychological Testing, Psychological Testing, and Neurobehavioral Status Exam<\/td>\n10\/1\/2025<\/span><\/b>\u00a0<\/span><\/td>\n\n
      \n
    • No change<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n","protected":false},"excerpt":{"rendered":"

      Please read the following update related to various Health New England programs and changes that may have an impact on your patients and\/or your practice. If you have any questions about the information in this notice, please contact Health New England Provider Experience at (800) 842-4464, extension 5000. A representative is available Monday through Friday […]<\/p>\n","protected":false},"author":11,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[92],"tags":[],"class_list":["post-8766","post","type-post","status-publish","format-standard","hentry","category-provider-newsletter"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZHB-2ho","_links":{"self":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/8766","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/comments?post=8766"}],"version-history":[{"count":2,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/8766\/revisions"}],"predecessor-version":[{"id":8768,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/8766\/revisions\/8768"}],"wp:attachment":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media?parent=8766"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/categories?post=8766"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/tags?post=8766"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}