Covered and Noncovered Services : Covered Services and Requirements

Co-treatment

Co-treatment is simultaneous treatment by two providers of different disciplines during a single member encounter. Co-treatment may be authorized when the treatment approach is medically necessary to optimize the member's benefit from behavioral treatment. Behavioral treatment providers may provide co-treatment with the following types of providers:

• Therapy
• Outpatient mental health
• PDN

Behavioral treatment providers are required to specify on the initial PA request or on a PA amendment request the plan for co-treatment with another provider. Co-treatment occurs when the member is present with both providers for a joint intervention, but it does not include professional collaboration or consultation. Co-treatment requests should address the specific and unique contribution of each provider.

If co-treatment is approved, two providers of different disciplines can be reimbursed by ForwardHealth for the same time period. For example, if a member is treated by an SLP provider and a behavioral treatment provider from 1:00 p.m. to 2:00 p.m., both providers could receive ForwardHealth reimbursement for one hour of treatment time. However, if co-treatment is not approved, neither the SLP provider nor the behavioral treatment provider would receive reimbursement for one hour. Instead, each provider could receive reimbursement for 30 minutes of treatment time.