Primary Care Provider (PCP) Requirements for Behavioral Health Services
The PCP must have behavioral health screening and evaluation processes available for detection, treatment or referral of members. PCPs are responsible for documenting in medical records any referrals and any known self-referrals for behavioral health services.
PCPs are encouraged to:
Maintain contact with their patient’s behavioral health provider.
Document behavioral health assessments and treatments – medical record documentation and referral information using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) multi-axial classifications.
Inform the behavioral health provider of any condition the member may have that could affect the behavioral health service.
Communicate and coordinate services essential to ensuring quality and continuity of care with the patient’s behavioral health provider.
Assist with behavioral health referrals and provide Magellan with supporting documentation.
Initiate a member referral for behavioral health services by contacting Magellan by phone at 800-327-7390 (TTY: 800-735-2988). Obtain consent for disclosure of information.
Behavioral Health Providers Behavioral health providers are encouraged to contact a member’s PCP to discuss the patient’s general health. Behavioral health providers must also contact members who have missed appointments within 24 hours to reschedule appointments per HHSC‑mandated provisions.
