On this page is a compilation of the obsolete pages as they
correspond to the revision date. Click on a date to see the manual chapter
page(s) prior to the revision.
Pages replaced from 12/02/2024 revision – Section 2.3 – Outpatient Services – Individual Placement and Support (IPS)
Pages replaced from 11/19/2024 revision – Appendix E-5 – Evidence Based Practices (EBP) – Child Parent Psychotherapy
Pages replaced from 10/01/2024 revision – Section 2.3 – Outpatient Services – Outpatient Therapy by Licensed Practitioners
Pages replaced from 10/01/2024 revision – Appendix E-5 – Evidence Based Practices (EBPs) – Child/Parent Psychotherapy
Pages replaced from 10/01/2024 revision – Appendix E-6 - Evidence Based Practices (EBPs) – Parent/Child Interaction Therapy
Pages replaced from 10/01/2024 revision – Appendix E-7 – Evidence Based Practices (EBPs) – Preschool PTSD Treatment and Youth PTSD Treatment
Pages replaced from 10/01/2024 revision – Appendix E-8 – Evidence Based Practices (EBPs) – Triple P Positive Parenting Program
Pages replaced from 10/01/2024 revision – Appendix E-9 – Evidence Based Practices (EBPs) – Trauma-Focused Cognitive Behavioral Therapy
Pages replaced from 10/01/2024 revision – Appendix E-10 – Evidence Based Practices (EBPs) – EMDR Therapy
Pages replaced from 10/01/2024 revision – Appendix E-11 – Evidence Based Practices (EBPs) – DBT Therapy
Pages replaced from 07/08/2024 revision – Section 2.2 – Bed Based Services (BBS) – Psychiatric Residential Treatment Facilities (PRTF)
Pages replaced from 07/08/2024 revision – Section 2.2 – Bed Based Services (BBS) – Therapeutic Group Homes (TGH)
Pages replaced from 06/17/2024 revision – Section 2.3 – Outpatient Services – Crisis Response Services
Pages replaced from 05/13/2024 revision – Section 2.3 – Outpatient Services – Outpatient Therapy by Licensed Practitioners
Pages replaced from 05/13/2024 revision – Appendix E-11 – Evidence Based Practices (EBPs) – Dialectical Behavioral Therapy (DBT)
Pages replaced from 04/30/2024 revision – Table of Contents
Pages replaced from 04/25/2024 revision – Section 2.3 – Outpatient Services – Personal Care Services (PCS)
Pages replaced from 04/15/2024 revision – Title Page
Pages replaced from 04/15/2024 revision – Section 2.3 – Outpatient Services – Personal Care Services (PCS)
Pages replaced from 02/26/2024 revision – Appendix F – CSoC Wraparound Model
Pages replaced from 02/05/2024 revision – Section 2.2 – Bed Based Services (BBS) – Crisis Stabilization for Adults
Pages replaced from 02/05/2024 revision – Section 2.3 – Outpatient Services – Crisis Response Services
Pages replaced from 01/12/2024 revision – Section 2.2 – Bed Based Services (BBS) – Crisis Stabilization for Youth
Pages replaced from 01/12/2024 revision – Section 2.2 – Bed Based Services (BBS) – Psychiatric Residential Treatment Facilities (PRTF)
Pages replaced from 01/12/2024 revision – Section 2.2 – Bed Based Services (BBS) – Therapeutic Group Homes (TGH)
Pages replaced from 01/12/2024 revision – Section 2.3 – Outpatient Services – Mental Health Rehabilitation (MHR) Services
Pages replaced from 01/12/2024 revision – Section 2.3 – Outpatient Services – Personal Care Services (PCS)
Pages replaced from 01/12/2024 revision – Section 2.3 – Outpatient Services – Outpatient Therapy by Licensed Practitioners
Pages replaced from 01/12/2024 revision – Section 2.4 – Addiction Services
Pages replaced from 01/12/2024 revision – Section 2.4 – Addiction Services – Opioid Treatment Program (OTP)
Pages replaced from 01/12/2024 revision – Appendix B – Glossary/Acronyms
Pages replaced from 01/12/2024 revision – Appendix C – Medical Necessity and EPSDT Exceptions
Pages replaced from 01/12/2024 revision – Appendix D – Approved Curriculum/Equivalency Standards
Pages replaced from 01/12/2024 revision – Appendix E-1 – Evidence Based Practices (EBP) – Assertive Community Treatment (ACT)
Pages replaced from 01/12/2024 revision – Appendix E-2 – Evidence Based Practices (EBP) – Functional Family Therapy (FFT) and Functional Therapy – Child Welfare (FFT-CW)
Pages replaced from 01/12/2024 revision – Appendix E-4 – Evidence Based Practices (EBP) – Multi-Systemic Therapy
Pages replaced from 01/12/2024 revision – Appendix E-5 – Evidence Based Practices (EBP) – Child Parent Psychotherapy
Pages replaced from 12/14/2023 revision – Section 2.3 – Outpatient Services – Crisis Response Services for Adults
Pages replaced from 11/13/2023 revision – Appendix D – Approved Curriculum and Equivalency Standards
Pages replaced from 11/13/2023 revision – Appendix F – CSoC Wraparound Model
Pages replaced from 10/31/2023 revision – Table of Contents
Pages replaced from 10/02/2023 revision – Appendix E-1 – Evidence Based Practices – Assertive Community Treatment (ACT)
Pages replaced from 09/01/2023 revision – Section 2.3 – Outpatient Services – Peer Support Services
Pages replaced from 08/15/2023 revision – Section 2.6 – Record Keeping
Pages replaced from 08/11/2023 revision – Section 2.6 – Record Keeping
Pages replaced from 08/04/2022 revision – Section 2.2 – Bed Based Services – Crisis Stabilization for Youth
Pages replaced from 07/17/2022 revision – Appendix E-2 – Evidence Based Practices – Functional Family Therapy (FFT) and Functional Therapy – Child Welfare (FFT-CW)
Pages replaced from 07/17/2022 revision – Appendix E-3 – Evidence Based Practices – Homebuilders
Pages replaced from 07/11/2023 revision – Section 2.3 – Outpatient Services – Outpatient Therapy by Licensed Practitioners
Pages replaced from 07/11/2023 revision – Section 2.3 – Outpatient Services – Crisis Response Services for Adults
Pages replaced from 07/07/2023 revision – Section 2.3 – Outpatient Services – Mental Health Rehabilitation Services
Pages replaced from 06/22/23 revision - Section 2.4 – Addiction Services
Pages replaced from 06/07/2023 revision – Appendix E-1 – Evidence Based Practices – Assertive Community Treatment (ACT)
Pages replaced from 05/12/2023 revision – Section 2.3 – Outpatient Services – Outpatient Therapy by Licensed Practitioners
Pages replaced from 05/12/2023 revision – Section 2.3 – Outpatient Services – Mental Health Rehabilitation Services
Pages replaced from 05/12/2023 revision – Section 2.4 – Addiction Services
Pages replaced from 03/27/2022 revision – Appendix B – Glossary and Acronyms
Pages replaced from 03/06/23 revision - Section 2.3 - Outpatient Services – Mental Health Rehabilitation Services
Pages replaced from 03/06/23 revision - Section 2.4 – Addiction Services
Pages replaced from 03/06/23 revision - Section 2.4 – Addiction Services - Opioid Treatment Programs (OTPs)
Pages replaced from 01/10/23 revision - Section 2.4 - Addiction Services – Opioid Treatment Programs (OTPs)
Pages replaced from 12/29/2022 revision – Table of Contents
Pages replaced from 12/29/2022 revision – Section 2.2 - Bed Based Services – Crisis Stabilization for Youth
Pages replaced from 12/29/2022 revision – Section 2.3 – Outpatient Services – Rehabilitation Services
Pages replaced from 12/29/2022 revision – Appendix A – Forms and Links
Pages replaced from 12/29/2022 revision – Appendix D – Curriculum/Equivalency Standards
Pages replaced from 12/29/2022 revision – Appendix G-1 – Standardized Assessment for Members Receiving CPST and PSR
Pages replaced from 12/29/2022 revision – Appendix G-2 - Supported Employment
Pages replaced from 12/27/2022 revision – Section 2.4 – Addiction Services
Pages replaced from 10/04/2022 revision – Section 2.3 – Outpatient Services – Peer Support Services
Pages replaced from 10/04/2022 revision – Section 2.5 – Coordinated System of Care (CSoC)
Pages replaced from 10/04/2022 revision – Appendix A – Forms and Links
Pages replaced from 10/04/2022 revision – Appendix F – CSoC Wraparound Model
Pages replaced from 08/17/2022 revision – Table of Contents
Pages replaced from 08/16/2022 revision – Section 2.3 – Outpatient Services – Individual Placement and Support (IPS)
Pages replaced from 07/6/2022 revision – Section 2.3 – Outpatient Services – Outpatient Therapy by Licensed Practitioners
Pages replaced from 06/27/2022 revision – Section 2.3 – Outpatient Services – Crisis Response Services for Adults
Pages replaced from 06/27/2022 revision – Appendix D – Approved Curriculum and Equivalency Standards
Pages replaced from 04/05/2022 revision – Section 2.3 – Outpatient Services – Personal Care Services (PCS)
Pages replaced from 02/25/2022 revision – Section 2.0 – Overview
Pages replaced from 02/25/2022 revision – Section 2.2 – Bed Based Services – Therapeutic Group Homes
Pages replaced from 02/25/2022 revision – Section 2.2 – Bed Based Services – Psychiatric Residential Treatment Facilities
Pages replaced from 02/25/2022 revision – Section 2.3 – Outpatient Services – FQHC and RHC
Pages replaced from 02/25/2022 revision – Section 2.3 – Outpatient Services – Peer Support
Pages replaced from 02/25/2022 revision – Section 2.3 – Outpatient Services – Outpatient Therapy by Licensed Practitioners
Pages replaced from 02/25/2022 revision – Section 2.4 – Addiction Services
Pages replaced from 02/25/2022 revision – Section 2.5 – Coordinated System of Care (CSoC)
Pages replaced from 02/25/2022 revision – Section 2.6 – Record Keeping
Pages replaced from 02/25/2022 revision – Appendix C – Medical Necessity and EPSDT Exceptions Policy
Pages replaced from 02/25/2022 revision – Appendix E-1 – Evidence Based Practices – Assertive Community Treatment (ACT)
Pages replaced from 02/25/2022 revision – Appendix E-2 – Evidence Based Practices – Functional Family Therapy (FFT) and Functional Therapy – Child Welfare (FFT-CW)
Pages replaced from 02/25/2022 revision – Appendix E-3 – Evidence Based Practices – Homebuilders
Pages replaced from 02/25/2022 revision – Appendix E-4 – Evidence Based Practices – Multi-Systemic Therapy (MST)
Pages replaced from 02/25/2022 revision – Appendix E-5 – Evidence Based Practices – Child Parent Psychotherapy (CPP)
Pages replaced from 02/25/2022 revision – Appendix E-6 – Evidence Based Practices – Parent Child Interaction Therapy (PCIT)
Pages replaced from 02/25/2022 revision – Appendix E-7 – Evidence Based Practices – Preschool PTSD Treatment and Youth PTSD Treatment
Pages replaced from 02/25/2022 revision – Appendix E-8 – Evidence Based Practices – Triple P – Standard Level 4
Pages replaced from 02/25/2022 revision – Appendix E-9 – Evidence Based Practices – Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
Pages replaced from 02/25/2022 revision – Appendix E-10 – Evidence Based Practices – Eye Movement Desensitization and Reprocessing (EMDR) Therapy
Pages replaced from 02/25/2022 revision – Appendix F – CSoC Wraparound Model
Pages replaced from 02/25/2022 revision – Appendix G – Standardized Assessments for Members Receiving CPST and PSR
Pages replaced from 02/23/2022 revision – Table of Contents
Pages replaced from 02/23/2022 revision – Appendix B – Glossary and Acronyms
Pages replaced from 02/23/2022 revision – Appendix D – Approved Curriculum Equivalency Standards
Pages replaced from 02/21/2022 revision – Table of Contents
Pages replaced from 02/15/2022 revision – Appendix A – Forms and Links
Pages replaced from 01/19/2022 revision – Section 2.3 – Outpatient Services - Rehabilitation Services for Children, Adolescents and Adults
Pages replaced from 12/21/2021 revision – Section 2.4 – Addiction Services – Opioid Treatment Programs
Pages replaced from 08/26/2021 revision – Section 2.1 – Provider Requirements
Pages replaced from 08/26/2021 revision – Section 2.2 – Bed Based Services – Therapeutic Group
Pages replaced from 08/26/2021 revision – Section 2.3 – Outpatient Services – FQHC and RHC
Pages replaced from 08/26/2021 revision – Section 2.3 – Outpatient Services – Peer Support
Pages replaced from 08/26/2021 revision – Section 2.4 – Addiction Services
Pages replaced from 08/26/2021 revision – Section 2.5 – Coordinated System of Care (CSoC)
Pages replaced from 08/26/2021 revision – Section 2.6 – Record Keeping
Pages replaced from 08/26/2021 revision – Appendix A – Forms and Links
Pages replaced from 08/26/2021 revision – Appendix C – Medical Necessity and EPSDT Exceptions Policy
Pages replaced from 08/26/2021 revision – Appendix D - Approved Curriculum/Equivalency Standards
Pages replaced from 08/26/2021 revision – Appendix E-1 – Evidence Based Practices – Assertive Community Treatment (ACT)
Pages replaced from 08/26/2021 revision – Appendix E-2 – Evidence Based Practices – Functional Family Therapy (FFT) and Functional Therapy – Child Welfare (FFT-CW)
Pages replaced from 08/26/2021 revision – Appendix E-3 – Evidence Based Practices – Homebuilders
Pages replaced from 08/26/2021 revision – Appendix E-4 – Evidence Based Practices – Multi-Systemic Therapy (MST)
Pages replaced from 08/26/2021 revision – Appendix E-5 – Evidence Based Practices – Child Parent Psychotherapy (CPP)
Pages replaced from 08/26/2021 revision – Appendix E-6 – Evidence Based Practices – Parent Child Interaction Therapy (PCIT)
Pages replaced from 08/26/2021 revision – Appendix E-7 – Evidence Based Practices – Preschool PTSD Treatment and Youth PTSD Treatment
Pages replaced from 08/26/2021 revision – Appendix E-8 – Evidence Based Practices – Triple P – Standard Level 4
Pages replaced from 08/26/2021 revision – Appendix E-9 – Evidence Based Practices – Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
Pages replaced from 08/26/2021 revision – Appendix E-10 – Evidence Based Practices – Eye Movement Desensitization and Reprocessing (EMDR) Therapy
Pages replaced from 08/26/2021 revision – Appendix F – CSoC Wraparound Model
Pages replaced from 08/23/2021 revision – Section 2.3 – Outpatient Services - OLP
Pages replaced from 05/27/2021 revision – Section 2.5 – Coordinated System of Care (CSoC)
Pages replaced from 05/27/2021 revision – Appendix D - Approved Curriculum/Equivalency Standards
Pages replaced from 02/25/2021 revision – Table of Contents
Pages replaced from 02/09/2021 revision – Table of Contents
Pages replaced from 02/05/2021 revision – Table of Contents
Pages replaced from 02/05/2021 revision – Appendix D – Approved Curriculum
Pages replaced from 02/05/2021 revision – Appendix E-4 – EBP – MST
Pages replaced from 02/03/2021 revision – Table of Contents
Pages replaced from 01/05/2021 revision – Table of Contents
Pages replaced from 01/05/2021 revision – Section 2.0 – Overview
Pages replaced from 01/05/2021 revision – Section 2.2 – Residential Services
Pages replaced from 01/05/2021 revision – Section 2.3 – Outpatient Services - OLP
Pages replaced from 01/05/2021 revision – Section 2.4 – OTP - Addiction
Pages replaced from 01/05/2021 revision – Appendix F – CSoC Wraparound
Pages replaced from 10/07/2020 revision – Table of Contents
Pages replaced from 09/14/2020 revision – Appendix E-1 – Evidence Based Practices – Assertive Community Treatment
Pages replaced from 08/04/2020 revision – Section 2.3 – Outpatient Services - OLP
Pages replaced from 06/30/2020 revision – Table of Contents
Pages replaced from 06/20/2020 revision – Section 2.3 – Outpatient Services – Rehabilitation Services for Children, Adolescents and Adults
Pages replaced from 05/29/2020 revision – Section 2.6 – Record Keeping
Pages replaced from 04/08/2020 revision – Section 2.3 – Outpatient Services – Rehabilitation Services for Children, Adolescents and Adults
Pages replaced from 03/30/2020 revision – Section 2.0 – Overview
Pages replaced from 03/30/2020 revision – Section 2.3 – Outpatient Services
Pages replaced from 01/01/2020 revision – Section 2.4 – Addiction Services
Pages replaced from 01/01/2020 revision – Section 2.5 – Coordinated System of Care
Pages replaced from 09/04/2019 revision – Appendix A – Forms and Links
Pages replaced from 07/16/2019 revision – Appendix E-5 - Evidenced Based Practices (EBPs) Policy – Child- Parent psychotherapy
Pages replaced from 07/16/2019 revision – Appendix E-6 - Evidenced Based Practices (EBPs) Policy – Parent-Child Interaction Therapy”
Pages replaced from 07/16/2019 revision – Appendix E-7 - Evidenced Based Practices (EBPs) Policy – Preschool PTSD Treatment and Youth PTSD Treatment
Pages replaced from 06/12/2019 revision – Table of Contents
Pages replaced from 06/12/2019 revision – Section 2.2 – Residential Services
Pages replaced from 06/12/2019 revision – Section 2.4 – Addiction Services
Pages replaced from 06/12/2019 revision - Appendix E-1 Evidence Based Practices (EBPs) Policy – Assertive Community Treatment
Pages replaced from 01/01/2019 revision – Section 2.3 – Outpatient Services – Rehabilitation Services for Children, Adolescents and Adults
Pages replaced from 11/27/2018 revision – Section 2.3 – Outpatient Therapy by Licensed Practitioners
Pages replaced from 11/27/2018 revision – Section 2.4 – Addiction Services
Pages replaced from 07/25/2018 revision – Section 2.5 – Coordinated System of Care
Pages replaced from 07/25/2018 revision – Appendix F – CSoC Wraparound Model
Pages replaced from 07/24/2018 revision – Section 2.3 - Rehabilitation Services for Children, Adolescents, and Adults
Page replaced from 06/29/2018 revision – Section 2.1 – Provider Requirements
Pages replaced from 06/29/2018 revision – Section 2.3 - Rehabilitation Services for Children, Adolescents, and Adults
Pages replaced from 06/29/2018 revision – Section 2.6 – Record Keeping
Pages replaced from 06/29/2018 revision – Appendix A Forms and Links
Pages replaced from 06/01/2018 revision – Section 2.3 – Outpatient Services – Rehabilitation Services for Children, Adolescents, and Adults
Pages replaced from 06/01/2018 revision - Appendix E-1 Evidence Based Practices – Assertive Community Treatment
Pages replaced from 06/01/2018 revision - Appendix E-2 Evidence Based Practices - Functional Family Therapy (FFT)/Functional Family Therapy-Child Welfare (FFT-CW)
Pages replaced from 06/01/2018 revision - Appendix E-3 Evidence Based Practices – Homebuilders®
Pages replaced from 06/01/2018 Appendix E-4 Evidence Based Practices – Multi-Systemic Therapy
Page replaced from 05/03/2018 revision – Section 2.3 Outpatient Services – Rehabilitation Services for Children, Adolescents, and Adults
Pages replaced from 04/20/2018 revision – Table of Contents
Pages replaced from 04/20/2018 revision – Section 2.1 – Residential Services
Pages replaced from 04/20/2018 revision – Section 2.2 - Behavioral Health in a Federally Qualified Health Center (FQHC) and Rural Health Center (RHC)
Pages replaced from 04/20/2018 revision – Section 2.2 - Outpatient Therapy by Licensed Practitioners
Pages replaced from 04/20/2018 revision – Section 2.2 - Rehabilitation Services for Children, Adolescents, and Adults
Pages replaced from 04/20/2018 revision – Section 2.3 – Addiction Services
Pages replaced from 04/20/2018 revision – Section 2.4 - Coordinated System of Care
Pages replaced from 04/20/2018 revision – Section 2.5 - Record Keeping
Pages replaced from 04/05/2018 revision – Section 2.1 – Residential Services
Pages replaced from 04/05/2018 revision – Section 2.2 – Outpatient Services – Rehabilitation Services for Children, Adolescents, and Adults
Pages replaced from 03/01/2018 revision – Table of Contents
Pages replaced from 02/23/2018 revision – Section 2.4 – Coordinated System of Care
Pages replaced from 02/23/2018 revision – Appendix D – Approved Curriculum and Equivalency Standards
Pages replaced from 12/18/2017 revision – Section 2.3. Additive Services
Pages replaced from 12/13/2017 revision – Table of Contents
Pages replaced from 12/13/2017 revision – Section 2.1 Provider Requirements
Pages replaced from 10/12/2017 revision – Table of Contents
Pages replaced from 10/12/2017 revision – Section 2.4 Record Keeping
Pages replaced from 10/12/2017 revision – Section 2.5 Record Keeping
Pages replaced from 10/12/2017 revision – Appendix B Glossary and Acronyms
Pages replaced from 10/06/2017 revision – Table of Contents
Pages replaced from 10/06/2017 revision – Section 2.4 Record Keeping
Pages replaced from 10/06/2017 revision – Appendix B Glossary and Acronyms
Pages replaced from 08/24/2017 revision – Table of Contents
Pages replaced from 08/24/2017 revision – Section 2.1 Provider Requirements
Pages replaced from 08/24/2017 revision – Appendix B Glossary and Acronyms
Pages replaced from 07/06/2017 revision – Behavioral Health Services in a FQHC/RQHC
Pages replaced from 07/06/2017 revision - Outpatient Therapy by Licensed Practitioners
Page replaced from 07/06/2017 revision – Rehabilitation Services
Pages replaced from 07/06/2017 revision – Appendix A – Forms and Links
Pages replaced from 07/06/2017 revision – Appendix B Glossary and Acronyms
Pages replaced from 07/06/2017 revision – Appendix D Approved Curriculum and Equivalency Standards
Pages replaced from 07/06/2017 revision – Appendix E-1 Evidence Based Practices – Assertive Community Treatment
Page replaced from 06/09/2017 revision – Table of Contents
Page replaced from 06/09/2017 revision - Overview
Pages replaced from 06/09/2017 revision – Section 2.1 – Provider Requirements
Page replaced from 06/09/2017 revision – Appendix A – Forms and Links
Page replaced from 04/03/2017 revision – Appendix A – Forms and Links
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