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NC Department of Health and Human Services
NC Division of
Medical Assistance
 
 

Residential Treatment Facility Services

DMA Clinical Policy and Programs
Phone Number 919-855-4290
Fax 919-715-9451

Residential treatment provides a structured, therapeutic and supervised environment to improve the level of functioning for recipients.  The Local Management Entity (LME) is the established portal of entry and completes an assessment and determines the appropriate level of care. There are four levels of residential treatment:

  • Residential Treatment Level I Service provides a low to moderate structured and supervised environment in a family setting, excluding room and board.
  • Residential Treatment Level II Service provides a moderate to highly structured and supervised environment in a family or program setting, excluding room and board.
  • Residential Treatment Level III Service (Residential Treatment High) has a highly structured and supervised environment in a program setting only, excluding room and board.
  • Residential Treatment Level IV Service (Residential Treatment Secure) has a physically secure, locked environment in a program setting only, excluding room and board.

For service requirements, coverage criteria and limitations, refer to Clinical Coverage Policy #8D-2, Residential Treatment Facility Services.

Additional information about Enhanced Mental Health Services is available in the July 2006 Special Bulletin, Authorization and Utilization Review for Behavioral Health Services (PDF, 88 KB).

Additional information about Inpatient Behavioral Health Services is available in Clinical Coverage Policy #8B, Inpatient Behavioral Health Services.

Information about budget initiatives affecting residential services is available on the MH/SA Residential Services Initiative web page.

Medicaid Bulletins

For changes and updates to coverage criteria, billing information, and other program requirements refer to the N.C. Medicaid general and special bulletins.

Residential Treatment Cost Report