Comprehensive Care Program

Comprehensive Care Program (CCP)

The Comprehensive Care Program (CCP) is an expansion of the THSteps program and other Medicaid programs as mandated by the Federal Omnibus Budget Reconciliation Act (OBRA) of 1989. The Act requires all states to provide treatment, which is medically necessary and federally allowable.

In May 1991, the Health Care Financing Administration (HCFA) issued a clarification, which expanded CCP services to include treatment for problems identified by any health-care professional, regardless of whether a formal EPSDT/THSteps check-up has been performed. This means that a client may receive these services without first receiving a THSteps check-up.

Client Eligibility

Clients eligible to receive CCP services must be THSteps eligible at the time of delivery. A client is ineligible to receive CCP services if the client:
  • Is over 21 years of age
  • Is a qualified Medicare Beneficiary (QMB)
  • Is presumptive eligible (PE), or
  • Requires emergency care only.

Medicaid providers whose services are available only under CCP are:

  • Comprehensive Outpatient Rehabilitation Facilities (CORF)
  • Freestanding psychiatric hospitals
  • Freestanding rehabilitation hospitals
  • Licensed dietitians
  • Occupational Therapists
  • Orthodontic and prosthetic suppliers
  • Private duty nursing providers, and
  • Speech language pathologists-developmental therapy

CCP Services

In the fee for service or PCCM areas, request for CCP services are first initiated by a request from the client’s physician. Prior authorization from the National Heritage Insurance Company (NHIC) is issued to determine and document the medical need for CCP services or benefits and is a condition for reimbursement. Some CCP services have mandatory prior authorization, with some allowing prior authorization by telephone.

Service Limitations

Reimbursement is considered for any health service that is medically necessary, appropriate and allowable according to the Federal Medicaid guidelines. The following services are not federally allowable:
  • Aids for daily living
  • Ancillary power sources and other types of stand-by equipment
  • Educational programs, supplies and equipment
  • Equine or hippo therapy
  • Exercise equipment, home spas, toys and therapeutic balls etc
  • Home care that does not require a licensed nurse
  • Respite care
  • Structural changes to homes
  • Take home drugs from hospitals
  • Tennis shoes
  • Therapy involving any breed of animal, and
  • Vehicle modification, mechanical and/or structural machines such as wheelchair lifts etc.

For questions and for the prior authorization of some CCP services over the phone, contact the CCP Customer Service Unit at 1.800.846.7470, or visit the CIDC website at