Updated Shell Case Guidance for Behavioral Health Providers
Acentra Health, in partnership with the Office of MaineCare Services (OMS), previously issued guidance on September 9, 2025 for providers to submit shell cases in Atrezzo for Acentra to determine whether a service for a child is medically necessary under ViatalCare for Kids (formerly EPSDT).
Providers may also submit shell cases in Atrezzo for adults receiving outpatient therapy, to address mental health diagnoses delivered by one provider and substance use services delivered by another provider when both are medically necessary and may run concurrently.
To request a shell case for H0004 HO, H0004 HOHQ, or H0004 HOU2 please follow the steps below.
- Call Acentra Health Provider Relations at 866-521-0027 (Option 3).
- Give Acentra Health the member’s information, procedure code, start date, and brief clinical justification when prompted.
- Acentra will create the shell case and give you the case ID. You must then add a note in Atrezzo, explaining:
- Why the service is medically necessary
- How your service differs from any services the member already receives
- How units will be used
- Treatment goals member is working towards
Acentra Health’s Clinical Team will review the request and determine approval under Section 65, Chapter II, 65.06-7 Comparable or Duplicative Services.
For questions regarding the Atrezzo shell case process please contact the Acentra Health Provider Relations Department through our live agent chat on our Acentra's website, at 1-866-521-0027, Option 3, or via email.