MedicaidCoverageMedium impact
Therapeutic Group Home - MEDICAID - LOUISIANA (New)
Humana·LA · Psychiatry, Pediatrics·Medicaid
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Summary
Humana introduces a new Medicaid policy for Therapeutic Group Home (TGH) services in Louisiana, establishing coverage criteria and reimbursement guidelines for residential mental health treatment for members under 21. The policy defines eligibility requirements, covered services, and non-reimbursable components for this community-based residential service.
Action Required
By January 1, 2025: Billing teams serving Louisiana Medicaid patients must review TGH service billing procedures to ensure compliance with new coverage criteria. Verify that all TGH claims include required documentation of LMHP oversight, 24-hour supervision necessity, and individualized treatment plans. Note that room and board, supervision costs, and non-treatment services are not reimbursable.