What Behavioral Health Providers Need to Know About the Providence Transition
05/06/2026
Carelon Ending Behavioral Health Management for Providence Health Plan Effective July 1, 2026
Carelon Behavioral Health has notified its Providence Health Plan network providers that it will cease management of behavioral health and ABA services for Providence's Commercial and Medicare members on July 1, 2026. Providers currently serving these patients need to understand the scope of the change and take steps to ensure continuity of care and uninterrupted billing.
Termination: July 1, 2026
BH + ABA services
Commercial + Medicare only
What Is Changing
Carelon Behavioral Health will no longer manage behavioral health or Applied Behavior Analysis (ABA) services on behalf of Providence Health Plan. This means that as of July 1, 2026, Carelon will no longer be the administrative intermediary for authorizations, claims, and network participation for affected Providence members. Providers who currently bill or coordinate through Carelon for these members will need to transition those workflows to Providence Health Plan directly.
Scope of the Change
Affected
- Providence Health Plan Commercial members
- Providence Health Plan Medicare members
- Behavioral health services
- ABA services
Not affected
- All other Carelon-managed plans
- Carelon network participation in other health plans
- Medicaid or other Providence product lines
What Providers Need to Do Before July 1
Review your patient panel
Identify all current patients covered under Providence Health Plan Commercial or Medicare who receive behavioral health or ABA services through your practice.
Update billing workflows
Claims for services on or after July 1, 2026, must be routed directly to Providence Health Plan — not through Carelon. Update your billing system accordingly before the cutover date.
Confirm network status with Providence
Contact Providence Health Plan to understand your participation status in their network post-July 1 and confirm whether a new or updated contract is needed.
Communicate with patients
Notify impacted patients of the administrative change. Patients should receive continuity of care, but understanding the transition can help prevent confusion about authorizations or ID cards.
Credentialing note: Your existing Carelon credentialing for Providence Health Plan will not automatically carry over to a direct Providence relationship. If you intend to remain in network with Providence after July 1, contact them directly to initiate or verify credentialing as soon as possible to avoid a gap in participation status.
Contacts
Carelon — pre-July 1 questions
National Provider Service Line
Mon–Fri, 8 AM–8 PM EST
Providence Health Plan — network, billing, and ongoing care
Mon–Fri, 8 AM–8 PM PST