Molina Healthcare covers outpatient mental health visits with a mental health provider. Inpatient mental health visits are covered through Washington State Medicaid. Members may self-refer for mental health services or visit their Primary Care Provider (PCP).
PCP Role in Assessing and Referring Members for Mental Health and Chemical
It is the primary care provider’s (PCP) responsibility to assess if a member has any symptoms of a mental health or chemical dependency condition. If the results of the assessment are positive for mental health or chemical dependency issues, the PCP is responsible for referring the member to the appropriate mental health or chemical dependency services. In addition, it is the
PCP’s responsibility to support and encourage the member toward recovery and educate the member on the benefits of treating these conditions as well as the risks. Information on the principles of recovery and provider strategies to support recovery can be found here.
Referral for Mental Health Services
The mental health benefit for Washington Medicaid beneficiaries is a two-tiered benefit. Outpatient mental health services for mild to moderate mental health conditions including psychotherapy, psychological testing, and medication management are covered under the managed care benefit. Members may also self-refer for mental health services. Please see the Molina Provider Website, or contact our Molina Member Services, for a list of participating mental health providers.
More intensive mental health services for members with more severe, chronic mental health conditions, including inpatient mental health, day treatment, and intensive case management services, are provided by the Regional Support Networks (RSNs) for members who meet Access to Care Standards. The RSNs maintain a crisis/access line for members to call for services. The RSNs contract with community mental health agencies and inpatient psychiatric facilities to deliver services.
The Access to Care Standards can be found here. Information on how to refer to RSNs and a list of RSN contracted providers is located here.
If you are not sure where to refer a member you may always refer to a Molina provider for an initial evaluation. The Molina case management team will identify members who may meet Access to Care Standards and coordinate a referral to the appropriate RSN. Additional information on Medicaid Mental Health services is included in the Health Care Authority Mental Health Provider Guide.
Referral for Chemical Dependency Services
All Medicaid Chemical Dependency treatment services, with the exception of medical detox in a hospital setting, are provided fee-for-service for Medicaid beneficiaries. Services are delivered by state-licensed chemical dependency providers. Information on how to refer a member for Chemical Dependency services can be found at the Alcohol and Drug Abuse Services and Information website, here.
How to find a mental health provider
Go to our Find a Provider page and follow these easy steps:
- Select your city or enter zip code
- “Distance Within”- Select miles of how far you want to travel
- “Coverage”- select Medicaid
- “Provider Type”- select “Behavioral Health”
- Click “Search”
Or click here.
For mental health technical and referral assistance please contact Molina Utilization Management department at (800) 869-7185.