Covered In-Plan Services

Prior Authorization

Some services require approval from PerformCare before you can use them. This is called prior authorization. You can visit our Prior Authorization page to learn more about this process. You can also call Member Services if you need help understanding this process.

Member Services contact info

Cumberland, Dauphin, Lancaster, Lebanon, and Perry counties: 1-888-722-8646

Franklin and Fulton counties: 1-866-773-7917

Levels of Care

In order to enhance PerformCare’s commitment to the health and well-being of the members we serve, we have compiled the information below in hopes of providing answers about treatment options available to members and families. We hope this information helps members, parents, and caregivers navigate the behavioral health system in counties served by PerformCare.

You can visit Find a Provider and call the provider directly, or you can call Member Services and ask for help finding a provider near you.

Children’s Services

Mental Health and Substance Use Disorder Outpatient Services (MH OP/SU OP)

  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • Serves all age ranges
  • Outpatient providers offer a wide range of specialties to address both mental health and substance use needs. Services may include evaluation, individual, family, and group therapy.

Targeted Case Management (TCM)

  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • Serves all age groups
  • Community-based service provided to adults or children with serious mental illness or emotional disorders. TCM is designed to ensure that individuals and their families gain access to needed medical, social, and educational services as well as other agencies to support individual needs.

Medication Management

  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • Serves all age groups
  • Medication management for psychiatric care

Youth Peer Support Services

  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • Serves ages 14 to 18
  • Provides specialized therapeutic interactions conducted by self-identified current (or former) consumers of behavioral health services who have achieved significant recovery. Peer Specialists are trained and certified to offer support and assistance in helping others in their recovery and community integration process.

Dialectical Behavior Therapy — Adolescents (DBT-A)

  • Offers individual and group therapy in outpatient clinics located in Dauphin and Lancaster counties
  • Serves adolescents (ages 13 to 18) from Cumberland, Dauphin, Lancaster, Lebanon, and Perry counties

IBHS-Group: After School Program (ASP)

  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • Serves ages 5 to 14 
  • The programs offer a therapeutic group environment that focuses on improving social skills, peer interactions, low self-esteem, problem solving skills, and anger management skills.

IBHS-Group: Stepping Stones 

  • Available to members living in Cumberland, Dauphin, Lebanon, and Perry counties
  • Serves ages 3 to 18
  • The program offers a therapeutic group environment that focuses on improving communication, compliance, social skills, and safety.
  • The program operates on a 3:1 participant-to-staff ratio.

IBHS-Group: Intensive Day Treatment (IDT)

  • Available to members living in Lancaster County
  • Serves ages 9 to 15
  • IDT is a center-based day program that includes school/education and mental health therapies. It is geared toward youth who are at risk for placement outside of their home or school district due to behavioral issues. The school district must agree with IDT and frequent communication between home and school is expected.

IBHS-Group: VISTA Foundation

  • Enhanced Integrated Behavioral Services (EIBS) is available to members living in Cumberland, Dauphin, Franklin, Lancaster, Lebanon, and Perry counties.
    • Serves youth ages 3 to 21 who have a diagnosis of autism.
    • The program offers support through behavior technicians and behavior consultants.
    • Applied behavior analysis (ABA) is the primary intervention utilized. 
    • The child’s/youth’s/adolescent’s school district must be in agreement with the educational components, as the authorization runs concurrent with the Individualized Education Plan.
  • The Early Intensive Behavioral Intervention Program (EIBI) is available to members living in Cumberland, Dauphin, Lebanon, Lancaster, and Perry counties.
    • Serves children ages 12 months through 6 years who have a diagnosis of autism.
    • This is a center-based program offering applied behavior analysis (ABA) overseen by a board-certified behavior analyst (BCBA) and a registered behavior technician (RBT) providing direct care and treatment intervention. 
    • The program also provides parental education and training with an expectation of participation in at least 50% of offered parental sessions.

IBHS-Individual: Intensive Behavioral Health Services (IBHS)

  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • Serves youth from birth to age 21
  • Individual behavioral health services: Mobile Therapy (MT), Behavior Consultation (BC) and Behavioral Health Technician (BHT)  
  • Applied behavior analysis (ABA): Behavior Analytic (BA), Behavior Consultation-ABA (BC-ABA), Assistant Behavior Consultation-ABA (Assist BC-ABA), and Behavioral Health Technician-ABA (BHT-ABA)

IBHS-Individual: Multi-Systemic Therapy (MST)

  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • Serves youth ages 10 to 18  
  • Evidence-based intensive family- and community-based treatment model for youth with serious behavioral problems, including delinquency, aggression, truancy, and other difficult-to-treat behaviors. MST includes training for parents to sustain change.

IBHS-Individual: Functional Family Therapy (FFT)

  • Offered to members living in Cumberland, Dauphin, Lancaster, Lebanon, and Perry counties
  • Serves ages 10 to 18
  • Evidence-based in-home treatment for youths with externalizing behaviors and their caregivers. Target behaviors typically include acting out, aggression, truancy, and substance use.

IBHS-Individual: Specialized In-Home Treatment Program (SPIN)

  • Offered to members living in Cumberland, Dauphin, Lancaster, Lebanon, and Perry counties
  • Serves youth up to age 21
  • Uses the CBT/Relapse prevention model with a multi-systemic approach and trauma-informed care for youths with problem sexual behaviors at low to moderate risk for re-offense

IBHS-Individual: Youth Fire-Setter Assessment Consultation Treatment Service (YFACTS)

  • Offered to members living in Cumberland, Dauphin, Lancaster, Lebanon, and Perry counties
  • Serves youth up to age 21
  • In-home treatment for individuals with a history of fire setting or inappropriate use of fire or current fire setting/inappropriate use of fire. Provides a comprehensive assessment period followed by treatment plan development and treatment delivery.

Family-Based Mental Health Services (FBMHS)

  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • Serves youth up to age 21
  • FBMHS are geared toward youth who are at risk for out-of-home treatment due to behavioral/emotional issues. Services are provided to youth and caregivers in the home and community setting by a two-person team, offering 24/7 crisis intervention support and case management services.

Specialized Family-Based Mental Health Services (Problem Sexual Behaviors-FBMHS)

  • Offered to members living in Franklin and Fulton counties
  • Serves youth up to age 21
  • Offers fundamental FBMHS service with a specialized focus on youth with problem sexual behaviors. Addresses committing offense and completes cycle work, psychoeducation, family work, and reunification while transitioning the member back into the community setting.

Mental Health Partial Hospitalization Program (MH PHP)

  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • Serves ages 7 to 17 — population varies by provider
  • PHP offers day programming for mental health needs through group therapy, individual and family therapy as needed, and psychiatric consultation.
  • Evidence-based treatment option for adolescents that is designed to address suicidal and non-suicidal self-injurious behavior, while working to solve life’s problems in a more adaptive way. Dialectical behavior therapy includes individual, family, and group therapies.

Community Residential Rehabilitation — Host Home or Intensive Treatment Program (CRR-HH/CRR-ITP)

  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • CRR-ITP is available to members living in Cumberland, Dauphin, Lancaster, Lebanon, and Perry counties only.
  • Serves youth up to age 18 — population varies by CRR-HH and CRR-ITP provider 
  • Delivers treatment delivered at a private residence of a family other than the home of the youth’s parents or caregivers. It is a structured living arrangement that offers individual/family therapy and psychiatric consultation within the community, while the youth attends school in the school district where the CRR is located.  
  • Treatment should be short-term, with the focus on returning to biological family or foster care.
  • Regular contact and planned visits to the family home/discharge setting are required as part of treatment to transfer skills.

Residential Treatment Facility (RTF)

  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • Serves youth up to age 18 (may serve ages 18 to 21 on a case-by-case basis)
  • Treatment is delivered in an intensive residential structured living arrangement that offers individual/family therapy and psychiatric consultation. The youth attends school on the RTF campus or in the school district where the RTF is located.  
  • Treatment should be short-term, with the focus on returning to biological family, foster care, or other discharge setting.
  • Regular contact and planned visits to the family home/discharge setting are required as part of treatment to transfer skills.

Mental Health Inpatient Hospitalization Program (MH IP)

  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • Serves all age groups — population varies by provider
  • 24-hour residential/hospital program for members at risk of harming themselves or others. Treats mental health needs through group therapy, individual and family therapy as needed, and psychiatric consultation.
  • Typically a brief length of stay to stabilize symptoms so the youth can return to community-based services

Services for adults age 18 and older

  • Available to members living in Cumberland, Dauphin, Lancaster, Lebanon, and Perry counties
  • Serves adults age 18 and older
  • Evidence-based treatment option that provides direct, 24/7, mobile services, including intensive mental health treatment, as well as rehabilitative and vocational supportive services to individuals with serious mental illness
  • Offered to members in outpatient clinics located in Cumberland, Dauphin, Lancaster, Lebanon, and Perry counties
  • Serves adults age 18 and older
  • Evidence-based treatment option designed to address specific mental health disorders and behaviors such as borderline personality disorder, while working to solve life’s problems in a more adaptive way. DBT includes individual, family, and group therapies.
  • Available to members living in Cumberland, Dauphin, Lancaster, Lebanon, and Perry counties
  • Serves adults age 18 and older who have serious mental illness and an intellectual disability
  • A team of a registered nurse and a behavioral intervention clinician provides behavioral support and consultative services to individuals, families, and agencies in various settings. The goals are assessing the presenting problem, identifying strengths and deficits, developing a behavioral plan, collecting data, educating staff and families, and training to continue interventions upon discharge from services. Average length of services is six to nine months. 
  • Available to members living in Cumberland, Dauphin, Lancaster, Lebanon, and Perry counties 
  • Serves adults age 18 and older
  • Program teaches emotional, cognitive, and social skills that help those diagnosed with mental illness live and work in their communities as independently as possible.
  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • Serves all age groups
  • Outpatient providers offer a wide range of specialties to address both mental health and substance use needs. Services may include evaluation, individual, family, and group therapy.
  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • Serves all age groups
  • Community-based service provided to adults or children with serious mental illness or emotional disorders. TCM is designed to ensure that individuals and their families gain access to needed medical, social, and educational services as well as other agencies to support individual needs.
  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • Serves all age groups
  • Medication management for psychiatric care
  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • Serves adults age 18 and older
  • Provides specialized therapeutic interactions conducted by self-identified current (or former) consumers of behavioral health services who have achieved significant recovery. Peer Specialists are trained and certified to offer support and assistance in helping others in their recovery and community-integration process.  

Available to members living in Cumberland, Dauphin, Lancaster, Lebanon, and Perry counties
  • Serves adults age 18 and older
  • Provides face-to-face medical/psychiatric assessments, can accompany members to appointments, offers medication education/support and on-call services, and can assist with providing long-acting injectables within the home.

  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • Serves adults age 18 and older — population varies by provider
  • PHP offers day programming for mental health needs through group therapy, individual and family therapy as needed, and psychiatric consultation.
  • Evidence-based treatment option for adolescents that is designed to address suicidal and non-suicidal self-injurious behavior, while working to solve life’s problems in a more adaptive way. Dialectical behavior therapy includes individual, family, and group therapies.

  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • Serves all age groups — population varies by provider
  • 24-hour residential/hospital program for members at risk of harming themselves or others. It treats mental health needs through group therapy, individual and family therapy as needed, and psychiatric consultation.
  • Typically a brief length of stay to stabilize symptoms so individual can return to community-based services

Substance use disorder (SUD) levels of care

Certified Recovery Specialist

  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • Serves adults age 18 and older
  • Trained peer professionals help others move through the recovery process and work closely with the Case Management staff to assist clients. The main goal is to focus on the recovery process. It assists individuals with developing individual service plans and other formal mentoring activities to increase participation in person-centered planning.
  • What Is a Certified Recovery Specialist?

Medication-assisted treatment (MAT)

  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • Serves all age groups
  • Medications in combination with counseling and behavioral therapies for the treatment of substance use disorders. A combination of medication and behavioral therapies is effective in the treatment of substance use disorders and can help some people to sustain recovery for opioid use disorders and alcohol use disorder medications.

Substance Use Disorder: Outpatient Services 

  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • Serves all age groups — population varies by provider

Substance Use Disorder: Intensive Outpatient Services 

  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • Serves all age groups — population varies by provider

Substance Use Disorder: Partial Hospitalization 

  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • Serves all age groups — population varies by provider
  • Available to members living in Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, and Perry counties
  • Serves all age groups — population varies by provider

Substance Use Disorder: Clinically Managed Low-Intensity Residential Services (Halfway House) 

Substance Use Disorder: Managed Medium-Intensity Residential Services (Non-Hospital-Based Rehab)

Substance Use Disorder: Medically Managed Intensive Inpatient Services (Hospital-Based Rehab)

Substance Use Disorder: Medically Monitored Intensive Inpatient Withdrawal Management (Detox)

Substance Use Disorder: Medically Managed Intensive Inpatient Withdrawal Management (Detox)

Substance Use Disorder: Medically Managed Intensive Inpatient Services, Hospital-Based (Hospital-Based Rehab)

Supplemental services

As a rule, services that are not listed in the PerformCare handbook are not paid for by PerformCare. However, it may be possible that PerformCare covers a service not listed. You or your provider should contact Member Services with questions about coverage for a service that is not listed in your handbook.

Non-covered services

All services that are not specifically listed as in-plan services or are not approved supplemental services are not covered under your HealthChoices behavioral health program.

Other services available to you or your family

There may be other services and community supports available for you or your family. They may be provided through the County Mental Health and Drug and Alcohol programs in your area. PerformCare can help you get those services. We can help explore any costs that may apply to you.

The PerformCare staff works with other individuals and agencies to help organize your treatment and support. They include your primary care doctor; the Area Agency on Aging; and the Children, Youth, and Family Social Service Provider.

Members