This brief is designed to help providers understand and implement effective strategies and processes for health plan/managed care plan (MCP) billing activities related to services and supports provided when a beneficiary is participating in the CARE process.
If a claim for services provided under CARE is denied, you have the right to dispute the denial through the Department of Managed Healthcare’s Independent Medical Review & Complaint Process.
Per updates in Senate Bill 27, as of January 1, 2026, bipolar I with psychotic features, except psychosis related to intoxication, is an eligible diagnosis. This resource has been updated to reflect this update. For more information, see the Senate Bill 27 brief.