Psychiatric residential treatment facilities
Effective July 1, 2017, Select Health will provide coverage for services rendered at a Psychiatric Residential Treatment Facility (PRTF) for eligible members. This benefit includes psychiatric care provided to children under age 21. If services are provided immediately before the member reaches age 21, services may continue until the earlier of the date the member no longer requires the services or the date the member reaches age 22.
Members are referred for PRTF services by a Licensed Practitioner of the Healing Arts (LPHA) via the completion of the PRTF treatment request form, below. The PRTF referral form can be completed by the admitting facility, current treatment provider, or referral source. For questions regarding a member who is receiving PRTF services, please contact Select Health Behavioral Health Utilization Management (SH BH UM) at 1-866-341-8765 and ask to speak to a licensed clinician regarding PRTF placements.
Prior authorization of PRTF services
- All initial admissions and continued stays require prior authorization. Certain documentation is required for completion of the medical necessity review.
- For detail information regarding the prior authorization process and documentation requirements, see the PRTF quick reference guide, below.
For claims filing instructions, consult the claim filing manual. (PDF)