MedicaidAdministrativeMedium impact
Targeted Case Management Services Plan of Care Policy Clarification
Kentucky Medicaid·KY · Psychiatry·Provider Letter
Effective date
May 26, 2023
We identified it
Jun 20, 2026
Summary
Kentucky Medicaid clarifies that no policy change has occurred for Targeted Case Management (TCM) services - existing requirements for comprehensive assessments and specific TCM care plans remain in effect. MCOs have been directed to revisit recent audits that found overpayments based on this clarification.
Action Required
Immediately: Behavioral health providers should review recent TCM audit findings and ensure all treatment plans include specific TCM goals and objectives related to assessed needs. Contact DMS.Issues@ky.gov if you received overpayment determinations that may need to be revisited under this clarification. Verify that comprehensive care plans have dedicated sections for TCM-specific goals developed collaboratively with clients.