Skip to main content

Behavioral Health

WellCare provides behavioral health benefits to members enrolled in our Medicaid plans. We are committed to quality service and partnership with providers to ensure members get the most of their benefits.


Some behavioral health services may require prior authorization, including services provided by non-participating providers. Obtaining appropriate authorization is essential to providing needed care.

WellCare uses the following:

  • InterQual criteria: Assesses level-of-care criteria. 
  • American Society of Addiction Medicine, Inc. (ASAM): Assesses level of care determinations for substance-related disorders                            

Authorization Requirements

South Carolina Medicaid Authorization rules for Professional Services Inpatient.

South Carolina Medicaid Authorization rules for Professional Services Outpatient.

Access updated DAODAS Discrete Services with Benefit Limits.


Behavioral Health Forms

Behavioral Health Service Request Form: Applied Behavior Analysis (ABA) For Autism Spectrum Disorder

South Carolina Department of Mental Health CMHC Treatment Review and Authorization Request


Need help? We're here for you.

Contact Us
Last Updated On: 5/25/2016