Frequently Asked Questions

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Will there be a standard form for the child's Treatment plan? For the assessments to determine medical necessity for each service?

There will not be a standard template for the treatment plan. A sample form for recommending services/ documenting medical necessity can be found here: https://www.health.ny.gov/health_care/medicaid/redesign/behavioral_health/children/docs/example_lpha_recommendation_memo.pdf

No specific assessment tool needs to be completed for a child to access CFTSS; all that is needed is for the child to meet medical necessity criteria for the service.

Care Managers can refer directly to a CFTSS provider who is designated for OLP, for the non-physician licensed behavioral health practitioner to determine medical necessity for any CFTSS.

In addition, any licensed practitioner treating the child (such as their doctor) can make a recommendation to CFTSS by completing a written recommendation to document medical necessity based on clinical judgement.

Source: UM for CFTSS: OLP, PSR, CPST 9.18.18