AlohaCare to Assume CCS Administration for Ohana Health Plan
Beginning in October 2026, AlohaCare will assume administration of the Community Care Services (CCS) program currently managed for Ohana Health Plan.
Although many operational details are still being finalized, several important changes have already emerged.
Outpatient Providers
For routine outpatient behavioral health providers, the most notable change announced to date is that prior authorization will now be required for:
- CPT 90846 – Family psychotherapy without the patient present
- CPT 90847 – Family psychotherapy with the patient present
Providers who routinely bill these services should begin preparing their clinical workflows to accommodate the new authorization requirements.
Free-Standing Behavioral Health Facilities
The larger challenge affects free-standing behavioral health facilities billing on the UB-04.
Unlike Ohana’s current claims processing methodology, AlohaCare primarily adjudicates facility claims using Revenue Codes, and the list of currently allowable revenue codes is significantly more limited.
At present, AlohaCare recognizes:
- 0905–0906 – Intensive Outpatient Program (IOP)
- 0912–0913 – Partial Hospitalization Program (PHP)
- 0919 – Outpatient Facility Services (commonly utilized for ASAM Level 1.5 services)
This creates uncertainty for numerous ancillary behavioral health HCPCS services that facilities commonly report under revenue codes, including:
- 0914
- 0915
- 0916
- 0917
- 0918
- 0919 (depending on service)
Examples include, but are not limited to:
- H0001
- H0002
- H0004
- H0007
- H2011
- H2012
- H2023
- H2024
As of today, it remains unclear how many of these services will ultimately be recognized, mapped, or reimbursed under AlohaCare’s CCS implementation.
Access Revenue Hawaii is actively monitoring these developments and working with payers and industry partners to better understand the future billing methodology. We will continue providing updates as additional guidance becomes available.