As part of the Vaya Health and Partners Health Management merger, Vaya Partners will implement updates to several in lieu of service (ILOS) offerings upon plan launch on Oct. 1, 2026. Most services will continue without disruption; however, providers should review the following key operational, authorization, billing, and service updates to ensure readiness for implementation.
Key changes at a glance:
| Service | Update |
| Behavioral Health Urgent Care (BHUC) | · Service name has been standardized across the network as BHUC.
· Former Partners network providers will implement Tier III (T2016 U5) and Tier IV (T2016 U6) service levels. · Previous utilization limits have been removed. · Providers must notify Vaya Partners when rapid recidivism occurs with multiple visits within a 30 to 90-day period. |
| Family-Centered Treatment (FCT) | · For former Vaya network providers, prior authorization is no longer required.
· A notification service authorization request (SAR) is required, with a six-month passthrough period. |
| High-Fidelity Wraparound (HFW) | · For former Vaya providers, CANS and CALOCUS are no longer required from the medical necessity review.
· A notification SAR is required within one week of service initiation. |
| In-Home Therapy Services (IHTS) | · For former Partners network providers, prior authorization is required only when IHTS is stacked with another enhanced service.
· Initial and reauthorization occur every six months. |
| Child Assertive Community Treatment (Child ACT) | · Eligibility has been expanded from ages 10-18 to 10-19.
· Virtual service delivery may occur in limited extenuating circumstances. · Treatment interventions, team composition requirements, and additional staff training expectations have been updated/defined. |
| Long-Term Community Supports (LTCS) | · Therapeutic Leave will be reimbursed.
· The minimum number of hours for meaningful day activity has been updated. · Staffing ratio requirements have been updated. |
| Institute for Mental Disease (IMD) | · Providers must notify Vaya Partners within 72 business hours of admission.
· Initial mental health and substance use authorizations have been aligned to seven days, with a 72-hour passthrough period. |
| Rapid Care Services | · The updated staffing model requires a Qualified Professional (QP).
· Billing codes have been updated to S9480 U5 (Low Intensity) and S9480 HK U5 (High Intensity). |
| Rapid Response Services for Children and Youth | Name has changed from Rapid Response Beds to Rapid Response Services for Children and Youth. |
| Transitional Youth Services | The billing structure has been updated to one unit per month. |
| New Services Available to Former Vaya Network Providers | Residential Services – Complex Needs will become available throughout the expanded network. |
| New Services Available to Former Partners Network Providers | Outpatient Plus, Enhanced Crisis Response, First Episode Psychosis ACT, and Dual Diagnosis-Capable ACT will become available throughout the expanded network. |
ILOS code changes:
| Service | Vaya Codes | Partners Codes | Vaya Partners Codes |
| BHUC | T2016 U5 or T2016 U6 | T2016 U5 | T2016 U5 or T2016 U6 |
| Child ACT | H0040 U5 HA; H0040 U5 HA TS Encounters | H0040 U5 HA; H0040 U5 HA EN Encounters | H0040 U5 HA; H0040 U5 HA TS Encounters |
| Rapid Care Services | S9480 U5 – Low; S9480 HK U5 – High | S9484 U5: Rapid Care Services Low; S9484 HK U5: Rapid Care Services High | S9480 U5 – Low; S9480 HK U5 – High |
What do I need to do?
- Review updated service definitions, authorization requirements, and billing guidance.
- Update internal workflows for IMD admission notifications, BHUC recidivism reporting, and notification SAR processes.
- Ensure staffing models align with revised requirements, where applicable.
- Prepare billing systems for code and unit updates effective Oct. 1, 2026.
- Review newly available ILOS services and identify opportunities to expand service offerings within your organization.
Where can I find additional information?
Additional ILOS information will be available soon on our new website at VayaPartners.org.
Who do I contact if I have questions?
Prior to Oct. 1, 2026, please use the following contacts:
- Partners authorization questions: UMQuestions@partnersbhm.org
- Partners claims questions: ClaimsDepartment@partnersbhm.org
- Partners Provider Account Specialists: PAS@partnersbhm.org
- Vaya Provider Network Contract Managers: info@vayahealth.com
On or after Oct. 1, 2026, please direct inquiries to: