CurrentOptumPolicy N/A

Louisiana ARPA State Incentive Payments for EBP providers and LMHPs/psychiatrists

Governance of incentive payments funded by the American Rescue Plan Act (ARPA) to recruit and retain evidence-based practice (EBP) providers and to incentivize licensed mental health professionals (LMHPs) and psychiatrists delivering home and community-based services in Louisiana Medicaid managed care; affects MCOs and enrolled providers July 1, 2023–June 30, 2024 or until funds exhausted.

Policy Summary

PayerOptum

PolicyLouisiana ARPA State Incentive Payments for EBP providers and LMHPs/psychiatrists

Policy CodePolicy N/A

Change TypeNo material changes

Effective Date7/1/2023

Next Review DateN/A

Key ActionProviders must submit the required ARPA invoice and documentation (W-9, EBP certification, proof of paid training if applicable) to the specified MCO email to receive incentive payment.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

7/1/2023-6/30/2024performance period

$321.31one-time LMHP payment

$2,916 - $6,250recruitment payment range

$1,416 - $1,916retention payment range

60 days

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credentialing processing time

09/30/2024ARPA invoice deadline

Incentive Eligibility and Coverage Criteria

Incentive payment criteria

Eligibility and payment criteria for recruitment, retention, and LMHP/psychiatrist incentives

ALL of the following

Provider must be enrolled in the MCO network (some criteria require enrollment with all 6 MCOs to maximize payment)
For retention and LMHP/psychiatrist payments, provider must have been enrolled for at least 6 consecutive months prior to or during July 1, 2023 through June 30, 2024
Provider must have delivered at least one eligible home- or community-based EBP service during the performance period and have a successfully submitted and paid claim using the applicable EBP tracking code

ALL of the following

Applies to newly enrolled EBP providers who completed qualifying EBP certification on or after January 1, 2021 and are enrolled in the MCO network
Payments vary by EBP and whether provider self-paid training; amounts per MCO range from $2,916 to $6,250 depending on EBP and 'With/Without Training Cost' status
To be eligible for the maximum training payment, providers must be credentialed with all 6 MCOs

ALL of the following

Applies to existing EBP providers with >=6 months enrollment and at least one eligible service/claim during July 1, 2023–June 30, 2024
Payment amounts per MCO range approximately $1,416 to $1,916 depending on the EBP provided
Certification and training documentation must have been submitted, reviewed, and approved for the provider to receive retention payments

ALL of the following

Eligible LMHPs and psychiatrists must have been enrolled >=6 consecutive months prior to or during July 1, 2023–June 30, 2024 and provided at least one paid home- or community-based service during the performance period
Gross payment of $321.31 per MCO when criteria are met

ALL of the following

Services rendered in inpatient facilities or Place of Service 21 or 51 are not eligible for incentive payments

ALL of the following

A provider may earn a recruitment bonus, retention payment, and LMHP/Psychiatrist payment in the same performance year if the criteria for each are met

ALL of the following

Each MCO requires submission and approval of proof of EBP certification/qualification per EBP
MCO must have received and paid at least one eligible claim with the correct tracking code for the provider to receive payment

ALL of the following

ANY of the following
- Child Parent Psychotherapy: With Training Cost $6,250.00; Without Training Cost $4,083.33
- TF-CBT: With Training Cost $3,083.33; Without Training Cost $2,916.67
- Triple P Level 4: With Training Cost $4,333.33; Without Training Cost $3,666.67

ARPA incentive eligibility and documentation

Eligibility and documentation requirements for receiving ARPA incentive payments (effective 07/01/2023-06/30/2024):

ALL of the following

Provider must be in-network with the applicable MCO (e.g., Aetna Better Health of Louisiana) and in good standing to receive ARPA incentives

ALL of the following

Submit a separate ARPA invoice per individual provider using the MCO template; payment will be sent to the W-9 address unless EFT is completed
Invoices and required documentation must be submitted by 09/30/2024; payments issued within 60 days of completed documentation

ALL of the following

Providers must submit current qualifying EBP certification when the incentive requires EBP certification (qualifying codes: EB02–EB08)

Eligibility and submission criteria for EBP credentialing and incentive payments

Conditions and documentation required to be recognized as an EBP provider and to receive incentive/payment:

ALL of the following

Provider must be in good standing and in-network (credentialed/contracted) to be eligible for incentive payments

ALL of the following

Aetna requires the Aetna ARPA Incentive Payments Submission Form, one invoice per individual provider, W-9, current qualifying EBP certification (if applicable), and invoice/paid bill for training if applicable; submit to LABHPROVNET@aetna.com with subject 'ARPA Incentive'; invoices due by 09/30/2024; payments within 60 days of complete documentation

ALL of the following

Optum requires the completed ARPA Provider Incentives MCO Invoice Form, Authorization Form for EFT transfers, and a voided check showing proof of payment for training for reimbursement; submit to state_directed_payments@optum.com or networkse@optum.com as instructed

EBP invoicing requirements

Submission and documentation scenarios and requirements

ALL of the following

Providers are required to complete the Joint MCO EBP Invoice Form

ALL of the following

A Certificate of Completion of the EBP shall be attached to the Invoice Form

ALL of the following

Send proper documentation and invoice to the MCO-specific submission email (example: lamedicaidproviderrelations@humana.com for Humana; lainterpr@healthybluela.com for Healthy Blue)

ALL of the following

Billing Codes and Service Requirements

EBP and LMHP/Psychiatrist codesmixedCovered

EB02	Child-Parent Psychotherapy tracking code; CPTs 90832/90834/90837/90846/90847
EB03	Parent-Child Interaction Therapy tracking code; CPTs 90832/90834/90837/90846/90847
EB04	Youth PTSD Treatment tracking code; CPTs 90832/90834/90837/90846/90847
EB05	Preschool PTSD Treatment tracking code; CPTs 90832/90834/90837/90846/90847
EB06	Triple P Level 4 tracking code; CPTs 90832/90834/90837/90846/90847
EB07	TF-CBT tracking code; CPTs 90832/90834/90837/90846/90847
EB08	EMDR tracking code; CPTs 90832/90834/90837/90846/90847
90791-90880,96105-96167,99202-99213	Psychiatrist/LMHP CPT/HCPCS codes listed for eligible services and evaluations

Psychiatrist/LMHP codesCPTCovered

90791	Psychiatric Diagnostic Evaluation
90792	Psychiatric Diagnostic Evaluation With Medical Services
90832	Psychotherapy, 30 Minutes With Patient Present
90834	Psychotherapy, 45 Minutes With Patient Present
90837	Psychotherapy, 60 Minutes With Patient Present
90839	Psychotherapy For Crisis; First 60 Minutes
90845	Medical Psychoanalysis
90846	Family Psychotherapy Without Patient Present
90847	Family Psychotherapy With Patient Present
90849	Multiple Family Group Psychotherapy

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Minimum enrollment duration

Minimum enrollment durationProvider must have been enrolled in the MCO network for at least 6 consecutive months prior to or during the performance period (July 1, 2023 - June 30, 2024).

Applies to retention and LMHP/psychiatrist payments6-month continuous enrollment requirement is specifically required for retention payments and LMHP/psychiatrist incentive eligibility.

Enrollment timingConsecutive enrollment may be prior to or during the performance period — providers meeting the 6-month consecutive requirement at any time in that window are eligible.

Service requirement

Service requirement (actionable)Provider must have delivered at least one eligible home or community-based EBP service during the performance period (July 1, 2023 - June 30, 2024) and have a successfully submitted and paid claim using the applicable EBP tracking code.

Provider Submission, Invoicing, and Reconciliation Actions

Billing Rule

Claim tracking codes and ineligible places of service

Use the specified EBP tracking codes on paid claims and note ineligible places of service. Services delivered in an inpatient facility or billed with Place of Service 21 or 51 are not eligible for incentive payments.

EB02 — Child-Parent Psychotherapy (CPP) — CPT/HCPCS: 90832, 90834, 90837, 90846, 90847
EB03 — Parent-Child Interaction Therapy (PCIT) — CPT/HCPCS: 90832, 90834, 90837, 90846, 90847
EB04 — Youth PTSD Treatment (YPT) — CPT/HCPCS: 90832, 90834, 90837, 90846, 90847
EB05 — Preschool PTSD Treatment (PPT) — CPT/HCPCS: 90832, 90834, 90837, 90846, 90847
EB06 — Triple P Standard Level 4 — CPT/HCPCS: 90832, 90834, 90837, 90846, 90847
EB07 — Trauma‑Focused Cognitive Behavioral Therapy (TF-CBT) — CPT/HCPCS: 90832, 90834, 90837, 90846, 90847
EB08 — EMDR Therapy — CPT/HCPCS: 90832, 90834, 90837, 90846, 90847

Key Definitions

EBP provider

DefinitionEvidence-Based Practice (EBP) provider: a provider who has completed EBP certification/qualification in an applicable EBP (per LA Medicaid BHS Provider Manual Appendices E-5 through E-10) on or after January 1, 2021 and is enrolled in the MCO network.

Certification requirementEach MCO requires submission and approval of proof of EBP certification/qualification for the specific EBP to receive incentives.

Maximum payment conditionTo be eligible for maximum training payment, the EBP provider must be credentialed with all six MCOs.

LMHP/Psychiatrist

Eligible clinician typesLicensed Mental Health Practitioners (LMHPs) and psychiatrists who have been enrolled in the MCO network for at least 6 consecutive months and provided at least one paid home- or community-based service during the performance period.

Payment amount

Policy Summary

PayerOptum

PolicyLouisiana ARPA State Incentive Payments for EBP providers and LMHPs/psychiatrists

Policy CodePolicy N/A

Change TypeNo material changes

Effective Date7/1/2023

Next Review DateN/A

Key ActionProviders must submit the required ARPA invoice and documentation (W-9, EBP certification, proof of paid training if applicable) to the specified MCO email to receive incentive payment.

SourceLink

On This Page

Each MCO requires submission and approval of EBP certification and may take up to 60 days to add certification to provider profile

ALL of the following

Individual providers can be accounted for by only one agency; duplicative incentives across agencies are not allowed
MCOs must perform reconciliation within six months after the end of FY2024 and may recoup payments if warranted; report to LDH required

ALL of the following

LMHPs who provided at least one home or community-based service and had at least one paid eligible claim will receive a one-time payment of $321.31 per MCO when the MCO has received and paid at least one eligible claim

ALL of the following

Providers must complete credentialing (Louisiana Standardized Credentialing or CAQH attestation) and submit ownership/disclosure, W-9, EBP certification and other required documents; allow up to 60 calendar days for processing
Out-of-network providers may apply for network participation; completed applications processed within 60 days

ALL of the following

ARPA incentives are available from 07/01/2023–06/30/2024 or until funds are exhausted

ALL of the following

Examples of submission contacts: LABHPROVNET@aetna.com (Aetna), state_directed_payments@optum.com (Optum), lainterpr@healthybluela.com (Healthy Blue), lamedicaidproviderrelations@humana.com (Humana)

Optum will complete initial credentialing within 60 days of receipt of a completed credentialing application; loading EBP expertise can take up to 30 days

ALL of the following

Healthy Blue requires completion of the joint MCO EBP Invoice Form with certificate of completion attached; send documentation to lainterpr@healthybluela.com; payments made quarterly

ALL of the following

Humana requires CAQH attestation (within 180 days) or Louisiana State Standardized Application, current EBP certification, behavioral health staff roster, agency license/accreditation, W-9, and certificate of EBP training; average turnaround less than 45 days

ALL of the following

Providers must complete the Joint MCO EBP Invoice Form and attach a Certificate of Completion of the EBP; submit to the MCO-specific submission addresses; payments may be made quarterly

ALL of the following

UnitedHealthcare contact: Provider Call Center 1-866-675-1607 or networkse@optum.com; some Optum/UnitedHealthcare information is still being reviewed/finalized

ALL of the following

Where reimbursement for training is claimed, providers must submit an invoice/paid bill or voided check showing proof of payment for training

ALL of the following

Individual providers can be accounted for by only one agency; duplicate incentives across multiple agencies are not allowed

ALL of the following

Some MCOs (e.g., ABHLA) issue payment within 60 days of complete documentation; ARPA funds are available 07/01/2023–06/30/2024 or until funds exhausted; some MCOs pay quarterly

ALL of the following

Providers must submit CAQH or Louisiana credentialing materials, W-9, ownership/disclosure and other enrollment documents; submitting an application does not guarantee network participation

ALL of the following

Facilities must submit facility credentialing application and W-9; acceptance into the network is not guaranteed

ALL of the following

To be identified as eligible to offer the EBP in provider systems and directories, providers must submit all required documentation; failure to meet requirements may cause claims to deny

ALL of the following

Re-credentialing occurs per MCO schedules (examples: ACLA re-credentialing at least every three years) and supporting documents must be current at decision date

ALL of the following

Submission contacts include: LABHPROVNET@aetna.com, state_directed_payments@optum.com, lainterpr@healthybluela.com, LouisianaMedicaidCredentialing@humana.com, LABHMedicaid@Humana.com

Payments shall be made quarterly (per Healthy Blue and Humana highlights)

Operational note: Agency staffing scenario: if one agency uses a provider part time and another uses full time providers, document references this scenario but provides no operational detail

Eligible settingServices must be home or community-based; services in inpatient settings or Place of Service 21 or 51 are not eligible.

Claim documentationMCO must have received and paid at least one eligible claim with the correct tracking code for the provider to receive payment.

Documentation Required

ARPA incentive submission

Providers must submit required ARPA incentive documentation to the MCO indicated and meet provider enrollment/credentialing requirements. Invoices and supporting documents must be complete and submitted by the MCO-specific deadlines to receive payment.

Invoice: use the MCO Collaborative ARPA Incentive Template (one provider per invoice) or the MCO-specific ARPA/Joint MCO EBP Invoice Form as directed
W-9: current W-9 required; payments sent to name/address on the W-9
EFT Authorization/Voided Check: required if opting for EFT or when requested for proof of payment for training
EBP Certification: current/most recent qualifying EBP certificate must be submitted where applicable
Invoice/Paid Bill for Training or Voided Check showing proof of payment for training, when provider self-financed training
Submission deadlines: Aetna invoices no later than 09/30/2024; other MCOs per their guidance or until funds exhausted
Where to submit: Aetna — LABHPROVNET@aetna.com (Subject: ARPA Incentive); Optum — state_directed_payments@optum.com; follow each MCO’s submission instructions

Prior Authorization

Directed payment reconciliation

Directed payments will be reconciled to actual service delivery. The MCO will perform reconciliation within six months after the end of FY2024 and provide a reconciliation report to LDH. MCOs may recoup bonus amounts if adjustments indicate overpayment.

Reconciliation window: within six (6) months of the end of FY2024 the Contractor/MCO will perform reconciliation and provide a report to LDH using a mutually agreeable template
Payments contingent on provider meeting eligibility criteria (enrollment, service delivery, documentation)
MCOs reserve the right to recoup bonus amounts if warranted

Documentation Required

Aetna ARPA Incentive submission requirements

Aetna-specific submission requirements and process for ARPA incentive payments. Providers must be in good standing and in-network, submit one invoice per provider, and provide all supporting documentation. Payments are issued after completed documentation is received.

Complete: Aetna ARPA Incentive Payments for Behavioral Health Services Submission Form
Invoice: MCO Collaborative ARPA Incentive Template; one provider per invoice
W-9: required; payment issued to provider/name on W-9
EBP Certification: current/most recent copy if applicable
Invoice/Paid Bill for Training: if applicable
Submission email: LABHPROVNET@aetna.com (Subject line: ARPA Incentive)
Deadline: invoices no later than 09/30/2024
Eligibility: providers must be in good standing with Aetna Better Health of Louisiana and have completed credentialing/contracting and be In‑Network
Payment timing: within 60 days of receipt of all completed documentation

Documentation Required

Optum ARPA/state-directed payment submission

Optum/state-directed payment submission requirements. Submit the completed Optum/state ARPA invoice form and proof of bank information as directed. Payment processing begins after all required documentation is received.

Required forms: Completed American Rescue Plan Act (ARPA) Provider Incentives MCO Invoice Form
EFT Authorization Form (ACH) and/or voided check showing proof of payment for training where applicable
All forms available at the Optum/Welcome Louisiana provider forms site
Submission email: state_directed_payments@optum.com
Payment begins when all required documentation is received

Note

Joint MCO EBP invoice submission

Joint MCO EBP invoice process: providers must complete the Joint MCO EBP Invoice Form, attach a Certificate of Completion (or qualifying EBP certification) and submit to the MCO-specific email addresses listed by each participating MCO. Payments are processed per each MCO’s schedule (typically quarterly).

Complete the Joint MCO EBP Invoice Form (one provider per invoice where required)
Attach Certificate of Completion or qualifying EBP certification to the invoice
Attach invoice/paid bill for training or voided check if training was self‑funded
Submit invoices and documentation to the MCO-designated email: Healthy Blue — lainterpr@healthybluela.com; Humana — lamedicaidproviderrelations@humana.com; follow other MCO-specific submission addresses as published
Payment cadence: Healthy Blue and Humana indicate quarterly payments; follow each MCO’s stated payment timing

Eligible LMHPs/psychiatrists receive a gross one-time payment of $321.31 per MCO when criteria are met.

Setting requirementServices must be provided in home and community-based settings (not in institutions, hospitals, or residential facilities).

With/Without Training Cost

With Training CostPayment tier for recruitment when the practitioner provides documentation that they self-paid for EBP training (e.g., cleared/cancelled check, receipt, bank statement).

Without Training CostPayment tier used when the practitioner did not self-finance training (training provided at no cost by an MCO or the Center for Evidence to Practice); the MCO pays the 'Without Training Cost' amount.

Documentation requiredProof of self-payment (for 'With Training Cost') must be submitted to the MCO to qualify for the higher payment tier.

Louisiana-licensed Mental Health Practitioner

Definition (term)Louisiana-licensed Mental Health Practitioner: includes Medical Psychologist, Licensed Psychologist, Licensed Clinical Social Worker, Licensed Professional Counselor, Licensed Marital and Family Therapist, Licensed Addictions Counselor, or Advanced Practice Registered Nurse with relevant psychiatric/mental health specialty credentials.

Role in eligibilityThis classification is used to determine LMHP eligibility for ARPA incentives when the practitioner meets enrollment and service criteria.

Lower Licensed Providers

Ineligibility statementLower Licensed Providers are not eligible for ARPA Incentive payments.

Scope implicationOnly providers meeting the listed Louisiana-licensed Mental Health Practitioner classifications qualify; lower licenses are excluded from incentive eligibility.

Completed credentialing application

Completed credentialing application (definition)A credentialing application considered 'completed' includes all necessary documentation, attachments, and a signed agreement (or required CAQH attestation) submitted to the MCO; processing timelines (e.g., 60 calendar days) apply from receipt of a completed application.

Use in eligibilityProviders must have a completed credentialing application processed to be granted network effective dates and to be identified as eligible to offer EBP services in provider systems.

Temporary status noteProviders may be granted temporary credentialing status until the application is fully completed, per Louisiana law and MCO processes.

Joint MCO EBP Invoice Form

Form requirementThe Joint MCO EBP Invoice Form is the required invoice template providers must complete to request incentive/payment for EBP services across participating MCOs.

One invoice per providerSome MCOs require individual provider invoices (e.g., Aetna requires one invoice per provider); confirm MCO-specific guidance when completing the form.

Submission contactsThe completed form and required attachments must be sent to the MCO-specific submission emails (e.g., lamedicaidproviderrelations@humana.com for Humana; other MCO emails listed in guidance).

Certificate of Completion of the EBP

Certificate of Completion (actionable)A Certificate of Completion of the EBP (proof of EBP training) must be attached to the Joint MCO EBP Invoice Form when submitting for payment.

What qualifies as proofThe certificate is the documented proof of EBP training required for incentive eligibility and must match the EBP listed (e.g., CPP, PCIT, TF-CBT, EMDR, etc.).

Submission and processingAttach the certificate to the invoice submission; MCOs will verify the certification as part of credentialing/eligibility and payment processing (allow time for verification per MCO timelines).