Family Centered Treatment (FCT) — Coverage Criteria (H0037)
Defines provision rules for Family Centered Treatment (FCT/H0037) for CareSource PASSE providers in North Carolina, clarifying service exclusivity with other home and community-based services and allowance for certain counseling/crisis services per the Counseling and Crisis Provider Manual.
No material clinical or coverage changes in this revision.
Coverage Criteria for Family Centered Treatment (FCT)
Coverage for FCT (H0037)
Covered when ALL of the following are met
FCT is intended for children, adolescents, and families at risk for out-of-home placement and as an alternative to residential, hospital, or correctional placement
Ensures focused and effective care during FCT sessions
Other home and community-based services are excluded from being provided during Family-Centered Treatment (FCT) sessions (billing code H0037). This exclusivity requirement ensures focused delivery of the intensive in‑home treatment model and is a condition of coverage for FCT.
Provision of other home and community-based services concurrently with FCT sessions is not permitted and may be considered non‑compliant with this policy. Providers must not bill or deliver other HCBS for the same time period as FCT unless an exception is explicitly allowed by the Counseling and Crisis Provider Manual and documented as medically necessary.
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