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Evidence-based practices (EBPs) are interventions based on scientific evidence demonstrating that they improve client outcomes in treatment. The Kentucky Department of Medicaid Services (DMS) has requested all Managed Care Organizations survey network Behavioral Health providers on what EBPs they currently utilize upon enrollment and at least annually thereafter.  

Please complete this brief 6-question survey on the EBPs you use in your practice. It will take approximately 2 minutes.

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* 1. Provider Name (For an individual Provider report the name of the provider.  For an organization or group provide the organization or group name)

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* 2. NPI associated with the above Provider

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* 3. TIN

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* 4. Please select your provider type:

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* 5. Please select all of the Evidence-Based Practices (EBPs) you use in your practice.  If you do not use EBPs, please check the 'I do not use Evidence-Based Practices' option.

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* 6. Comments

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