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Prior Authorization/Intensive In-Home Mental Health and Substance Abuse Services Assessment and Recovery/Treatment Plan Attachment

Assigned Number Title Release Date File Type Language Available to Order
F-00212 Completion Instructions 12/16/2019 PDF English No
F-00212 Prior Authorization/Intensive In-Home Mental Health and Substance Abuse Services Assessment and Recovery/Treatment Plan Attachment 02/01/2010 PDF English No
F-00212 Prior Authorization/Intensive In-Home Mental Health and Substance Abuse Services Assessment and Recovery/Treatment Plan Attachment 02/01/2010 Word English No
Last revised April 26, 2024