The AmeriHealth Caritas Delaware behavioral health benefit for members under the age of 18 is limited to thirty (30) units per calendar year. After the member has reached 30 units of behavioral health service for the calendar year, providers should obtain a prior authorization and payment for future applied behavioral analysis (ABA) services from the Delaware Division of Developmental Disabilities Services (DDDS).
Members 18 and older who participate in PROMISE and receive these services become the responsibility of the State and are paid through the State’s Delaware Medicaid Enterprise System DMES:
- Substance use disorder services other than medically managed intensive inpatient detoxification.
- Licensed behavioral health practitioner services.
- Community psychiatric support and treatment, including Assertive Community Treatment (ACT)/Intensive Care Management (ICM).
- Community-based residential supports excluding assisted living.
- Peer support.
- Psychosocial rehabilitation.
Training and resources
Delaware Senate Bill (SB) 109
In collaboration with the state of Delaware, AmeriHealth Caritas Delaware abides by SB 109, amending 18 Del.C. §§ 3343 and 3578 and 31 Del.C. §524, to increase access and decrease barriers to needed substance use treatments.