MMC Benefits Handbook
Mental Health/Substance Use
  • Services performed in connection with conditions not classified in the current edition of the Diagnostic and Statistical Manual of the American Psychiatric Association
  • Services for mental health and substance use that extend beyond the period necessary for short-term evaluation, diagnosis, treatment or crisis intervention
  • Treatment for conduct and impulse control disorders, personality disorders, paraphilias
  • Treatment provided in connection with or to comply with commitments, police detentions and other similar arrangements, unless authorized by the Plan's preauthorization review service
The Plan's preauthorization review service may consult with professional clinical consultants, peer review committees or other appropriate sources for recommendations and information regarding whether a service or supply meets criteria
  • Intensive behavior therapies such as Applied Behavior Analysis
  • Preventive counseling provided in connection with tobacco dependency in excess of 8 visits per 12 months