Tennessee Medicaid Episodes Of Care Payments Go Live For Oppositional Defiant Disorder

On February 1, 2017, Tennessee launched a cross-payer episode of care bundle for children and adolescents ages 4 to 18 diagnosed with oppositional defiant disorder (ODD). The initiative includes Medicaid as one of the payers. A 180-day episode includes only care provided with a primary diagnosis of ODD, or a primary diagnosis for ODD specific symptoms and a secondary diagnosis code for ODD, as well as a specific list of medications.

According to a summary of the ODD episodes of care, an episode begins the day of the first claim with an ODD diagnosis. The trigger event is . . .