Children and Family Treatment and Support Services

SPA services are Rehabilitative services under the EPSDT benefit and available to children/youth under the age of 21 who are Medicaid eligible, that meet medical necessity. All SPA services can be delivered in the community where the child/youth lives, attends school, and/or engages in services. Proposed services include: Other Licensed Professional (OLP), Crisis Intervention, Community Psychiatric Supports and Treatment (CPST), Psychosocial Rehabilitation Services, Family Peer Support Services, Youth Peer Advocacy and Training. Some website content may include outdated information. Please refer to date posted for historical reference. Content will be updated in an effort to include the most recent material.

  • Children's Services Billing Change Webinar - October 18th and 19th, 2023
    • Children's Services Billing Change Webinar for MMCPs (Recording) - October 18, 2023
    • Children's Services Billing Change Webinar for Providers (Recording) - October 19, 2023
  • Updates to Billing Requirements for Children's HCBS, CFTSS, and 29-I OLHRS - (Web) - (PDF) - September 5, 2023
  • Changes to Billing Requirements for Children's HCBS and CFTSS FAQ - (Web) - (PDF) - November 21, 2023
  • Children's Services Billing Change Webinar - (PDF) - October 18th and 19th, 2023
  • PHE Unwind Guidance Regarding CFTSS Flexibilities - (Web) - (PDF) - June 27, 2023
  • CFTSS Provider Manual for EPSDT Services - (Web) - (PDF) - Updated March 2023
  • Overview of CFTSS Manual Updates - (Web) - (PDF) - March 2023
  • CFTSS Provider Guidance: Health Record Documentation - (Web) - (PDF) - June 2022
    • Overview of CFTSS Health Record Documentation Updates - (Web) - (PDF) - June 2022
  • Effective Changes to the Children's Waiver of Home and Community Based Services (HCBS) and CFTSS
    (Web) - (PDF) - April 2020
  • Requirements for Service Providers Delivering CFTSS and Children's Home and Community Based Services (HCBS)
    (Web) - (PDF) - March 2020
  • COVID-19 Guidance for Designated CFTSS' Providers
    (Web) - (PDF) - March 2020
  • Guidance for Providers Regarding Student Interns and Limited Permits for CFTSS and HCBS
    (Web) - (PDF) - June 2019
  • Allowable Licensed Practitioners of the Healing Arts (LPHA) Memo
    (Web) - (PDF) - June 18, 2019
  • Other Licensed Practitioner (OLP) Memo
    (Web) - (PDF) - April 18, 2019
  • SPA Distinction Chart - (Web)
  • SPA 22-0077 (Licensed Psychologist added as allowable practitioner of CFTSS OLP) - Effective July 1, 2022
  • SPA 20-001 (EPSDT Expansion for Behavioral Health Kids-Crisis Intervention and Youth Peer Support) - Effective January 1, 2020
  • SPA 19-0003 (EPSDT Expansion of Behavioral Health Kids-OLP, CPST, PSR, FPSS) - Effective January 1, 2019 (PDF)
  • Rehab SPA (EPSDT Expansion for Behavioral Health Kids: Rehabilitation Services) (PDF)
  • Proposed and Approved State Plan Amendments

CFTSS:

  • CFTSS & HCBS Kids FIPS to County Locator Code Crosswalk - (XLSX) - (PDF)
  • FPSS, YPS, CPST, PSR, CI Rate Summary - (PDF) - Effective 11.1.2023
  • OLP Rates - (PDF) - Effective 11.1.2023

Guidance

  • Notification of Updated CFTSS Rates - (Web) - (PDF) - October 19, 2023
  • Notification of Updated Children's Services Rate Sheets - (Web) - (PDF) - November 14, 2022
  • Notification of Continuation of the 25% Rate Adjustment and 2022-2023 Budget Actions - (Web) - (PDF) - September 28, 2022

American Rescue Act (ARP) Section 9817 Enhanced FMAP and Spending Plan

  • Children's eFMAP Release of Funds Announcement - (PDF) - March 17, 2022
  • eFMAP Rate Changes for Children's Services - (PDF) - February 18, 2022

CFTSS

The State has approved the following Concurrent Review Authorization Request Form for CFTSS. The form was developed in collaboration with providers and Medicaid Managed Care Plans (MMCPs) as a sample template to capture the necessary information to substantiate medical necessity. CFTSS do NOT require Prior Authorization, however some MMCPs will require concurrent review authorization after the first three visits. This form can be used by providers who are making concurrent review authorization requests to MMCPs.

As a reminder, MMCPs are not permitted to conduct any utilization management of CFTSS for the first 90 days after implementation.

A list of MMCP specific authorization requirements can be found here.

  • CFTSS Continuing Authorization Request Form - (PDF) - January 7, 2019
  • EXAMPLE Medical Necessity Form - LPHA Recommendation for CFTSS (NOT A REQUIRED FORM, but a sample template to capture the information necessary to demonstrate medical necessity.) - (PDF) - December 5, 2019
  • Utilization Management Guidelines for Children's State Plan and Demonstration Services for Medicaid Managed Care Plans - (Web) - (PDF) - revised June 20, 2018
  • Notification Regarding Enhanced Rates for EBPs within CFTSS - (Web) - (PDF) - October 24, 2023
  • CFTSS Provider Guidance: Evidence Based Practices - (PDF) - July 2023