Substance Use Disorder (SUD) PT 03 Behavioral Health Service Organization (BHSO) Tier Selections:  

 

There are three tiers available for selection:  Tier 1 Mental Health, Tier 2 Outpatient SUD, and Tier 3 Residential SUD.  Can select one, two or all tiers based on services provided. Must select at least one Tier.

Substance Use Disorder (SUD) PT 66 Behavioral Health Multi-Specialty Group Selections:  

 

Special Characters:

 

 For First Name, Business Name, Other name (if any):    | + \ '

 For Last Name field:    | + \ ', and numbers are not allowed

 For Comment Boxes:     <  >  ^  ~ ` + | \ / ¬ £

 For Address fields:    | + ! @ # $ ^ * ( ) ? / \ " < > & : ; _

 

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