Therapeutic Group Home - MEDICAID - LOUISIANA

This policy covers Therapeutic Group Home (TGH) community-based residential behavioral health services for Humana Healthy Horizons in Louisiana (Medicaid) members under age 21, providing 24-hour intensive psychiatric supports, individual/family/group therapy, skill-building, and community integration in a home-like setting of no more than 10 beds. Coverage requires enrollment, a recommendation/authorization by a licensed mental health professional or physician with program oversight by a psychiatrist or psychologist and documentation that less restrictive treatments were unsafe/unavailable; services in institutions for mental disease (IMDs) and room-and-board are excluded and TGH is intended as a less restrictive alternative to inpatient/PRTF care.

"No documentation requirements are specified in the provided text."

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