Behavioral Health Services

Behavioral health can affect overall health. We want to help members get quality care for their mind and body. Behavioral health services are meant to help those facing:

Emotional needs or concerns
Mental health diagnosis
Substance abuse concerns

Sometimes, one or more of these conditions may exist at the same time. Or they may exist in addition to a physical condition.

The type of service needed depends on the situation. A Care Coordinator can help members find out what services are covered. He or she can also let you know if the service will need prior authorization (to be approved before you go for the service). If you need a Care Coordinator, call 1-877-232-5518.

Check the current Behavioral Health Level of Care Guidelines. If you have questions about these guidelines, ask your doctor or Care Coordinator.

What is covered?

Here are just some of the services covered by this plan:

Behavioral Health Services – List of services covered by this plan.
Covered Service	Applies to:	Does service need prior authorization?
Inpatient Psychiatric and Substance Abuse Services	All ages	Yes
Accredited Residential Treatment Services for Adults with Substance Abuse Disorders	18 years and older	Yes
Accredited Residential Treatment Center Services for Youth	Under age 21	Yes
Applied Behavioral Analysis	12 months and older	Yes, for some services
Crisis Intervention	All ages	No
Day Treatment	Under age 21	No
Electroconvulsive Therapy	All ages	No
Intensive Outpatient Programs for Mental Health and Substance Use Disorders	11 years and older	No
Medication Assisted Treatment	All ages	No
Partial Hospitalization	5 years and older	Yes, beyond 45 days
Peer Support Services	All ages	No
Psychological Testing	All ages	No
Therapy	All Ages	No, but services beyond core coverage may need prior authorization

You do not need a referral from your PCP to get these services. For a complete list of covered services, check the Member Handbook.

What is not covered?

Examples of services this plan does not cover include:

Hypnotherapy
Biofeedback
Experimental procedures or non-drug therapies
Services from non-licensed providers

For more information about behavioral health benefits, check the Member Handbook.

New Mexico Crisis and Access Line (NMCAL)

NMCAL is available to New Mexicans during a mental health crisis. Use this state-wide toll-free phone line to access local help and resources. There are mental health professionals ready to help 24 hours a day, 7 days a week.

Call NMCAL at 1-855-NMCRISIS (1-855-662-7474).

If you have a life-threatening emergency, please call 911.

Mental Health Hotlines

These hotlines are available 24/7. Calls are confidential and at no cost to you.

988 Suicide & Crisis Lifeline  – provides support for those who are in distress, as well as prevention and crisis information
National Maternal Mental Health Hotline  – provides support before, during and after pregnancy for those who feel overwhelmed, anxious or depressed

Learn How Your Plan Works

Review the Member Handbook for details about plan benefits.

FAQs

Find anwers to Frequently Asked Questions about this health plan.