What determines if recovery support activities are Medicaid billable?

The determination of whether recovery support activities are Medicaid billable is influenced by the individuals' treatment plan goals. This is because Medicaid typically requires that services provided to recipients are medically necessary and aligned with their specific treatment plans. The treatment plan outlines the goals and objectives tailored to the individual's needs, and recovery support activities that are directly linked to achieving those goals can be billed to Medicaid.

For example, if a recovery support activity directly addresses a goal established in a person's treatment plan, such as achieving sobriety or developing coping skills, it underscores the necessity and relevance of the support provided, making it billable under Medicaid.

In contrast, factors such as the location of service delivery, duration of service, or the type of recovery support group are important for logistical and operational purposes but do not alone determine the billability of services. They can influence how services are provided or structured but do not ensure that the activities align with a patient's treatment goals, which is essential for Medicaid reimbursement.