Resources for Behavioral Treatment Benefit Services
Wisconsin Medicaid Behavioral Treatment Benefit providers can use these resources to help support compliance with federal and state program rules, regulations, policies, and guidance.
Behavioral treatment benefit ForwardHealth Updates are listed below; note that information in older publications may have been updated by later publications. Providers should refer to the Behavioral Treatment Benefit service area of the ForwardHealth Online Handbook for complete and current behavioral treatment benefit policy.
2025-41, “Behavioral Treatment Benefit Policy Clarifications and ForwardHealth Online Handbook Revisions” (12/23/2025)
This Update informed providers of revisions to the ForwardHealth Online Handbook to clarify policy based on an audit.
2022-54 , “Expanded Coverage of Group Behavioral Treatment Services” (12/14/2022)
This Update informed providers of expanded coverage for group behavioral treatment services.
2019-37 , “Changes to HealthCheck Prior Authorization for Behavioral Health and Behavioral Treatment Services” (12/16/2019)
This Update clarified prior authorization (PA) requirements for behavioral treatment and certain behavioral health services that align with current HealthCheck Other Services PA policy.
2019-29 , “New Concurrent Coverage Policy for Behavioral Treatment Services With Behavioral Health Services” (11/13/2019)
This Update announced new coverage policy for the concurrent delivery of behavioral treatment services (applied behavior analysis services) with behavioral health services (mental health and/or substance use disorder services).
2018-46 , , “Behavioral Treatment Procedure Code Changes and New Prior Authorization Policy” (12/10/2018)
This Update provided updated coverage and reimbursement policies for providers.
2018-35 , “Reimbursement Rate Increase for Behavioral Treatment Services” (09/25/2018)
This Update informed providers of reimbursement rate increases for behavioral treatment services.
2018-29 , “Guidance for Behavioral Treatment for School-Age Youth” (09/10/2025)
This Update gave guidance to assist providers through the process of providing behavioral treatment for school-age youth.
2017-28 , “Changes to Coverage Policy and Prior Authorization Requirements for Behavioral Treatment” (09/05/2017)
This Update announced changes to behavioral treatment PA requirements and focused treatment coverage and also clarified policy.
2016-34 , “New and Clarified Policy for the Behavioral Treatment Benefit” (08/03/2016)
This Update clarified previously published behavioral treatment benefit policy and provided new information related to the benefit.
2015-62 , “New ForwardHealth Behavioral Treatment Benefit” (12/18/2015)
This Update announced coverage of the new behavioral treatment benefit and included policy and program information for the benefit.
2015-55 , “Provider Enrollment for the New Behavioral Treatment Benefit” (10/27/2015)
This Update informed providers about enrolling in Wisconsin Medicaid as a behavioral treatment provider.
Payment Integrity Review Supporting Documentation #22797
Online Handbook Topic
Supporting documentation requirements for payment integrity review (PIR)
Payment Integrity Review Program #22798
PIR program’s purpose and goals
Wisconsin Department of Health Services: Payment Integrity Review Program Training
Provider Trainings
Program overview, guidance, and process
Payment Integrity Review (PIR) Program Frequently Asked Questions
Wisconsin Department of Health Services (DHS) Publication
Questions and answers about common provider concerns
Office of the Inspector General Trainings
Behavioral Treatment-Specific Trainings
Additional Resources
Because you have not recently performed an action that loads or reloads a page, your session will expire in Upon expiration your unsaved data will be lost and you will be required to login again to begin a new session. To avoid a session expiration, click this button to extend your session.
Extend