Effective March 1, 2025: New Medicaid Benefit - Certified Family Partner Services

Date: 02/28/25

Superior HealthPlan would like to inform providers of the new Certified Family Partner (CFP) services benefit that will be offered to Superior Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS) and CHIP members. CFP services are provided to parents, Legally Authorized Representatives (LARs) and primary caregivers of Medicaid-eligible children and youth twenty (20) years of age and younger, diagnosed with a serious emotional disturbance, mental health, or substance use condition.

1.       Scope of CFP Services:

• Introducing parents, LARs, or primary caregivers to the mental health and substance use system
• Modeling advocacy skills
• Providing education and information
• Making referrals
• Providing skills training
• Assisting in identifying supports
• Conducting support groups
• Helping with navigating systems (e.g., juvenile justice, child protective services, independent school districts)

2.       CFP Certification Required

• A CFP certification is issued for a period of two years. A CFP must renew their certification every two years through the Texas Health and Human Services Commissions (HHSC)-approved designated certifying entity in Texas.
• Recertification requires a minimum number of continuing education hours, as required by the HHSC-approved designated certifying entity in Texas

3.       Superior Network Participation for CFPs:

• CFPs must be employed by a Superior contracted provider, with one of the following specialties:
  • Clinic and group practices treating behavioral health conditions
  • Physicians, Advanced Practice Registered Nurses (APRNs) and Physician Assistants (PAs) treating behavioral health conditions
  • Licensed psychologists, licensed clinical social workers, licensed marriage and family therapists, and licensed professional counselors
  • Comprehensive provider agencies of mental health targeted case management and mental health rehabilitative services
  • Local Mental Health or Behavioral Health Authorities (LMHA/LBHA)
  • Chemical dependency treatment facilities
  • Federally Qualified Health Clinics (FQHC)
  • Rural Health Clinics (RHC)
  • Opioid treatment providers

4.       Allowable Places of Service:

• Office, Home, Outpatient Hospital, Telehealth

5.       Prior Authorization requirements

• CFP services must be included the plan of care of the Medical eligible child or youth.
• Prior authorization is not required for the first 104 units (26 hours) of CFP services in a rolling 6-month period.

6.       Exclusions:

• A CFP cannot provide this service for their own child.

7.       Billing:

• A billable unit of CFP services is 15 minutes of continuous contact.

CFP Procedure Code/Description	Modifier Codes/Descriptions
S9482 Family partner support services, per 15 minutes	95 Synchronous Audiovisual Telehealth	FQ Synchronous Audio only Telehealth	HE Mental Health Program	HF Substance Use Program	HQ* Group Delivered Services

*If providing services in a group setting, modifier HQ should be billed in the first position.

For any questions or more information, please reach out to your dedicated Provider Representative. To access their contact information visit Find My Account Manager.