Psychiatric Residential Treatment Facilities (PRTF)
What is a PRTF?
A Psychiatric Residential Treatment Facility (PRTF) is a licensed inpatient mental health treatment program for children and youth under age 21.
PRTF services are for individuals who:
- Are under 21 years old.
- Have an active psychiatric diagnosis.
- Meet medical necessity criteria.
- Have approval from their Medicaid plan.
Important: A developmental disability diagnosis alone does not qualify someone for PRTF care. A psychiatric diagnosis is required.
Who Oversees and Pays for PRTFs
- PRTFs are licensed and monitored by the South Carolina Department of Public Health.
- Medicaid rates are set by the South Carolina Department of Health and Human Services.
- PRTFs are funded entirely by Medicaid.
Since July 7, 2017, PRTF services are managed through South Carolina Medicaid Managed Care Organizations (MCOs). This means your chosen Medicaid MCO:
- Approves admissions
- Authorizes length of stay
- Handles appeals
If a child has Fee-for-Service Medicaid, approval is handled by Acentra Health, the South Carolina Department of Health and Human Services (SCDHHS) quality improvement vendor.
South Carolina Medicaid MCOs
If your child has Medicaid, they are enrolled in one of these health plans:
- Absolute Total Care – 1-855-735-4398
- BlueChoice (Healthy Blue) – 1-800-868-2528
- Humana Healthy Horizons – 1-866-432-0001
- Molina Healthcare of South Carolina – 1-866-449-6848
- Select Health of South Carolina (First Choice) – 1-800-741-6605
Each MCO has its own approval and appeals process.
Who Can Make a Referral?
A PRTF referral can be started by:
- A parent or legal guardian.
- The Medicaid beneficiary (if appropriate).
- A state agency.
A referral does not require sponsorship from a state agency.
If the child does not have Medicaid, a referral may still be made. However, the family must arrange private payment or use private insurance if accepted by the facility.
Required Documents For Acceptance
1. Certificate of Need (CON)
Must be signed by:
- A physician
- A Licensed Practitioner of the Healing Arts (such as LMSW or LPC)
This document certifies that the child needs this level of care.
2. Diagnostic Assessment (DA)
- Must be completed by a Licensed Practitioner of the Healing Arts
- Can be completed by approved private providers
Length of Stay and Discharge Planning
PRTF treatment is short-term and stabilization focused.
It is not intended to be a long-term placement.
Discharge planning begins on the day of admission. The goal is to return the child to the community as soon as it is clinically appropriate.
The following individuals work together on discharge planning:
- The PRTF treatment team.
- The Medicaid MCO representative.
- The child’s case manager.
The MCO can assist with:
- Scheduling outpatient appointments.
- Coordinating community services.
- Ensuring a smooth transition home.