Home

First Managed Care Option

Rehabs That Take First Managed Care Option

First Managed Care Option is a name listed by treatment centers in New Jersey as a source of coverage. Coverage for drug and alcohol treatment may be available through the plan or program behind it, with benefits that vary by plan, by network and by level of care.New Jersey centers on this page list First Managed Care Option on their own websites. The name may relate to managed care for workers’ compensation or another program, so ask what coverage it applies to. Contact the organization and the facility before admission about network status, prior authorization and costs.

Rehab Centers Near You

Drug and Alcohol Rehab Centers That Accept First Managed Care Option

HMH JSUMC – Neptune

61 Davis Avenue, Neptune, NJ, 7753

3.9★★★★☆60

Joint Commission

DetoxPHPIOP+3

Accepts InsuranceAccepts MedicaidAccepts Medicare+4

Co-occurring DisordersMATTrauma-informed+9

Deaf and HoH

The address on record is 61 Davis Avenue in Neptune, New Jersey. According to the federal listing this provider runs intensive outpatient and outpatient care. The listing includes medication-assisted treatment, the approach with the strongest evidence for opioid dependence. People attend appointments and go home afterwards, which is how outpatient care works. Telehealth is listed, so some contact can happen without traveling in. Dedicated support is recorded for veterans and military families. Federal registration is…

2.2 miShark River33 miJohn F. Kennedy International AirportServes20 towns

Substances treated

Adderall Rehab · Alcohol MAT Friendly · Alcohol Medication Treatment · Alcohol Only Rehab · Alcohol Rehab · Beer Addiction Treatment · Binge Drinking Treatment · Carfentanil Rehab · Codeine Rehab · Concerta Rehab · +34 more

Levels of care

Aftercare and Continuing Care · Clonidine and Lofexidine Detox · Continuing Care · Detox by Substance · Detox Centers · Discharge Planning · Evening Treatment · Intensive Outpatient Program (IOP) · Non-12-Step Rehab · Online Rehab and Telehealth · +6 more

Therapies

Activity Therapy · Addiction Counseling · Brief Intervention · Cognitive Behavioral Therapy (CBT) · Counseling and Therapy · Couples Counseling · Dialectical Behavior Therapy (DBT) · Evidence-Based Therapy · Family Therapy · Group Therapy · +6 more

Mental health

Co-Occurring Mental Health Conditions · Depression and Anxiety · Depression and Trauma · Family Education Programs · Mental Health Conditions · Mental Health Treatment · Psychiatric Medication Management · Psychosocial Rehabilitation · Serious Emotional Disturbance · Social Skills Training · +1 more

Groups served

Adult Rehab · Couples Rehab · Court Ordered Rehab · DUI and DWI Programs · Hepatitis Support Services · HIV and Hepatitis Care · HIV Support Services · Men's Dual Diagnosis Rehab · Men's Medicare Rehab · Men's Outpatient Rehab · +40 more

Support services

Case Management · Health and Wellness Support · Health Education · Nutrition and Fitness Counseling · Peer Support · Practical Support · Recovery Support Services · Suicide Prevention Services · Transportation to Rehab

Languages

Deaf and Hard of Hearing Dual Diagnosis Rehab · Deaf and Hard of Hearing MAT · Deaf and Hard of Hearing Rehab

Insurance accepted

Aetna · AmeriHealth · Braven Health · Cigna Healthcare · Clover Health · Consumer Health Network · Devon Health · First Managed Care Option · Horizon Blue Cross · Humana · +13 more

Hackensack Meridan Health – Shrewsbury

661 Shrewsbury Avenue, Shrewsbury, NJ, 7702

3.5★★★★☆4

SAMHSA listed

PHPOutpatientTelehealth

Accepts InsuranceAccepts MedicaidAccepts Medicare+5

Co-occurring DisordersTrauma-informedVeterans+6

The site sits at 661 Shrewsbury Avenue in Shrewsbury, New Jersey. It is recorded as offering partial hospitalization, intensive outpatient and outpatient care. The record covers addiction and mental health provision together. People attend appointments and go home afterwards, which is how outpatient care works. Video appointments are recorded as an option here. Family involvement is listed as part of the provision. SAMHSA holds the federal registration and the New Jersey Division of Mental Health…

1.8 miSwimming River26 miNewark Liberty International AirportServes33 towns

Substances treated

Adderall Rehab · Concerta Rehab · Dexedrine Rehab · Nicotine and Tobacco Treatment · Nicotine Replacement Therapy · Prescription Stimulant Rehab · Ritalin Rehab · Smoking Cessation Counseling · Stimulant Rehab · Vaping Cessation · +1 more

Levels of care

Evening Treatment · Non-12-Step Rehab · Online Rehab and Telehealth · Outpatient Rehab · Partial Hospitalization Program (PHP) · Weekend Rehab

Therapies

Cognitive Behavioral Therapy (CBT) · Counseling and Therapy · Dialectical Behavior Therapy (DBT) · Evidence-Based Therapy · Family Therapy · Group Therapy · Individual Therapy · Integrated Dual Disorder Treatment

Mental health

Co-Occurring Mental Health Conditions · Depression and Anxiety · Depression and PTSD · Depression and Trauma · Family Education Programs · First Episode Psychosis · Illness Management and Recovery · Mental Health Conditions · Mental Health Treatment · Psychosocial Rehabilitation · +4 more

Groups served

Adult Rehab · Couples Rehab · Court Ordered Rehab · Senior Outpatient Rehab · Senior PHP · Senior Rehab · Senior Telehealth · Trauma Informed Rehab · Trauma Survivor Programs · Veterans and Military Rehab · +8 more

Support services

Case Management · Health and Wellness Support · Nutrition and Fitness Counseling · Recovery Support Services · Suicide Prevention Services

Insurance accepted

Aetna · AmeriHealth · Braven Health · Cigna Healthcare · Clover Health · Consumer Health Network · Devon Health · First Managed Care Option · Horizon Blue Cross · Humana · +13 more

Holy Name Pavilion – Teaneck

718 Teaneck Road, Teaneck, NJ, 7666

3.0★★★☆☆4

Federally certified

InpatientTelehealthWalk-in

Accepts InsuranceAccepts MedicaidAccepts Medicare+3

Co-occurring DisordersTrauma-informedSeniors+4

Holy Name Pavilion is based at 718 Teaneck Road in Teaneck, New Jersey. Provision here is recorded as residential treatment. Provision here is recorded as mental health treatment. This is residential provision, so someone lives at the facility throughout. Remote appointments appear on the record, useful where travel is difficult. Family involvement is listed as part of the provision. SAMHSA holds the federal registration and the New Jersey Division of Mental Health and Addiction Services…

5.2 miSaddle River3.5 miTeterboro AirportServes106 towns

Substances treated

Nicotine and Tobacco Treatment · Nicotine Replacement Therapy · Smoking Cessation Counseling · Smoking Cessation Medication · Vaping Cessation

Levels of care

Inpatient Rehab · Online Rehab and Telehealth · Walk-In Rehab

Therapies

Activity Therapy · Cognitive Behavioral Therapy (CBT) · Counseling and Therapy · Dialectical Behavior Therapy (DBT) · Evidence-Based Therapy · Family Therapy · Group Therapy · Individual Therapy · Integrated Dual Disorder Treatment · Specialized Therapy

Mental health

Alzheimer's and Dementia Care · Co-Occurring Mental Health Conditions · Depression and Anxiety · Depression and PTSD · Depression and Trauma · Family Education Programs · First Episode Psychosis · Illness Management and Recovery · Mental Health Conditions · Mental Health Crisis Services · +6 more

Groups served

Adult Rehab · Couples Rehab · Court Ordered Rehab · Rehab for Domestic Violence Survivors · Senior Rehab · Senior Telehealth · Trauma Informed Rehab · Trauma Survivor Programs · Young Adult Rehab

Support services

Case Management · Chronic Illness Management · Education and Job Training · Health and Wellness Support · Housing and Employment Support · Intensive Case Management · Nutrition and Fitness Counseling · Peer Support · Recovery Support Services · Suicide Prevention Services

Insurance accepted

1199SEIU Benefit Fund · Aetna · Ambetter (Centene) · American Progressive · AmeriHealth · Amerivantage · Anthem / Elevance Health · APWU Health Plan · Bergen Risk · Bollinger · +28 more

Hackensack Meridian Carrier Clinic – Belle Mead

252 County Road 601, Belle Mead, NJ, 8502

2.6★★★☆☆16

Joint Commission

DetoxHospital detoxInpatient+5

Accepts InsuranceAccepts MedicaidAccepts Medicare+2

Co-occurring DisordersMATTrauma-informed+8

Deaf and HoH

This location is registered at 252 County Road 601 in Belle Mead, New Jersey. Provision here is recorded as detox, residential treatment and intensive outpatient. Approved medication is used alongside counseling, which is what medication-assisted treatment means in practice. People stay on site for the duration, which is what inpatient care means here. Telehealth is listed, so some contact can happen without traveling in. Support for veterans appears on the record. Licensing sits with the…

6.3 miHerrontown Woods Arboretum15 miTrenton Mercer AirportServes42 towns

Substances treated

Adderall Rehab · Alcohol Detox · Alcohol MAT Friendly · Alcohol Medication Treatment · Alcohol Only Rehab · Alcohol Rehab · Ativan (Lorazepam) Rehab · Beer Addiction Treatment · Benzodiazepine Rehab · Binge Drinking Treatment · +49 more

Levels of care

14-Day Rehab · 21-Day Rehab · 30-Day Rehab · Addiction Retreat · Aftercare and Continuing Care · Alcohol Detox Program · Anxiety Retreat · Ativan (Lorazepam) Detox Program · Benzodiazepine Detox Program · Buprenorphine-Assisted Detox · +54 more

Therapies

12 Step Rehab · Addiction Counseling · Anger Management · Brief Intervention · Cognitive Behavioral Therapy (CBT) · Community Reinforcement Approach · Contingency Management · Counseling and Therapy · Evidence-Based Therapy · Family Therapy · +5 more

Mental health

Co-Occurring Mental Health Conditions · Depression and Anxiety · Depression and Trauma · Mental Health Conditions · Mental Health Treatment · Psychiatric Medication Management · Psychosocial Rehabilitation · Social Skills Training · Trauma Treatment

Groups served

Active Duty Military Detox · Active Duty Military Dual Diagnosis Rehab · Active Duty Military Medicare Rehab · Active Duty Military Outpatient Rehab · Active Duty Military Rehab · Active Duty Military Suboxone · Active Duty Military Telehealth · Active Duty Military Trauma Rehab · Active Duty Military TRICARE Rehab · Adult Rehab · +79 more

Support services

Case Management · Community Outreach · Employment Support · Health and Wellness Support · Health Education · Hepatitis C Treatment · HIV Treatment · Housing and Employment Support · Housing Assistance · Peer Support · +7 more

Languages

Deaf and Hard of Hearing Detox · Deaf and Hard of Hearing Dual Diagnosis Rehab · Deaf and Hard of Hearing MAT · Deaf and Hard of Hearing Rehab · Deaf and Hard of Hearing Residential Rehab

Insurance accepted

Aetna · AmeriHealth · Braven Health · Cigna Healthcare · Clover Health · Consumer Health Network · Devon Health · First Managed Care Option · Horizon Blue Cross · Humana · +13 more

HMH JFK University Medical Center – Edison

65 James Street, Edison, NJ, 8820

2.6★★★☆☆~~1,181~~

Joint Commission

DetoxIOPOutpatient+2

Accepts InsuranceAccepts MedicaidAccepts Medicare+4

MATTrauma-informedTeens+7

Spanish spokenDeaf and HoHHindi spoken+1

The facility is recorded at 65 James Street in Edison, New Jersey. The services listed are intensive outpatient and outpatient care. This is recorded as treating co-occurring conditions rather than one in isolation. Treatment is delivered without an overnight stay, around existing commitments. Video appointments are recorded as an option here. Family involvement is listed as part of the provision. Registration is federal, through SAMHSA; licensing is held with the New Jersey Division of Mental…

5.1 miSouth Branch Rahway River13 miNewark Liberty International AirportServes70 towns

Substances treated

Levels of care

Aftercare and Continuing Care · Clonidine and Lofexidine Detox · Continuing Care · Detox by Substance · Detox Centers · Discharge Planning · Evening Treatment · Intensive Outpatient Program (IOP) · Online Rehab and Telehealth · Outpatient MAT Clinic · +4 more

Therapies

12 Step Rehab · Addiction Counseling · Anger Management · Brief Intervention · Cognitive Behavioral Therapy (CBT) · Counseling and Therapy · Couples Counseling · Evidence-Based Therapy · Family Therapy · Group Therapy · +5 more

Mental health

Co-Occurring Mental Health Conditions · Depression and Anxiety · Family Education Programs · Mental Health Conditions · Mental Health Crisis Services · Mental Health Treatment · Psychiatric Medication Management · Psychosocial Rehabilitation · Social Skills Training

Groups served

Adult Rehab · Couples Rehab · Court Ordered Rehab · Hepatitis Support Services · HIV and Hepatitis Care · HIV Support Services · Men's Dual Diagnosis Rehab · Men's Medicare Rehab · Men's Outpatient Rehab · Men's Rehab · +33 more

Support services

Case Management · Education and Job Training · Health and Wellness Support · Health Education · Housing and Employment Support · Housing Assistance · Peer Support · Practical Support · Recovery Support Services · Suicide Prevention Services · +1 more

Languages

Deaf and Hard of Hearing Dual Diagnosis Rehab · Deaf and Hard of Hearing MAT · Deaf and Hard of Hearing Rehab · German Speaking Rehab · Hindi Speaking Rehab · Spanish Speaking Rehab

Insurance accepted

Aetna · AmeriHealth · Braven Health · Cigna Healthcare · Clover Health · Consumer Health Network · Devon Health · First Managed Care Option · Horizon Blue Cross · Humana · +13 more

Hackensack Meridian Carrier Clinic – Mahwah

1071 Ramapo Valley Road, Mahwah, NJ, 7430

Joint Commission

IOPOutpatientTelehealth+1

Accepts InsuranceAccepts MedicaidAccepts Medicare+2

Co-occurring DisordersMATTrauma-informed+9

The site sits at 1071 Ramapo Valley Road in Mahwah, New Jersey. On record, this provider offers intensive outpatient and outpatient care. Medication for opioid use disorder is offered here alongside talking treatment. People attend appointments and go home afterwards, which is how outpatient care works. Video appointments are recorded as an option here. Veterans and military families are recorded as a served group. Registration is federal, through SAMHSA; licensing is held with the New…

2.8 miRamapo Mountain State Forest17 miTeterboro AirportServes73 towns

Substances treated

Levels of care

Aftercare and Continuing Care · Continuing Care · Discharge Planning · Evening Treatment · Intensive Outpatient Program (IOP) · Non-12-Step Rehab · Online Rehab and Telehealth · Outpatient MAT Clinic · Outpatient Rehab · Overdose Prevention Education · +3 more

Therapies

Addiction Counseling · Anger Management · Brief Intervention · Cognitive Behavioral Therapy (CBT) · Contingency Management · Counseling and Therapy · Evidence-Based Therapy · Family Therapy · Group Therapy · Individual Therapy · +3 more

Mental health

Groups served

Active Duty Military Dual Diagnosis Rehab · Active Duty Military Medicare Rehab · Active Duty Military Outpatient Rehab · Active Duty Military Rehab · Active Duty Military Suboxone · Active Duty Military Telehealth · Active Duty Military Trauma Rehab · Adult Rehab · Court Ordered Dual Diagnosis Rehab · Court Ordered MAT · +57 more

Support services

Case Management · Community Outreach · Employment Support · Health and Wellness Support · Health Education · Housing and Employment Support · Housing Assistance · Peer Support · Practical Support · Recovery Support Services · +2 more

Insurance accepted

Aetna · AmeriHealth · Braven Health · Cigna Healthcare · Clover Health · Consumer Health Network · Devon Health · First Managed Care Option · Horizon Blue Cross · Humana · +13 more

Why Trust RehabSeekers.com?

RehabSeekers is an independent behavioral health directory covering drug and alcohol addiction and mental health treatment providers.

Learn More

Every listing has a source: an official register, a licensing record, or details the facility sent us.

Credentials shown honestly. Accreditation, licensing and registration listed separately.

Reviews shown exactly as written. Never edited, never removed because a facility asked.

No commission, no referral fees. Nothing a facility pays for changes where it appears.

Contact details always go direct. Calls reach the facility itself, never a call centre.

See where our data comes from and our editorial policy.

Common questions

Answered from what is listed here.

What is First Managed Care Option?

First Managed Care Option, Inc., known as First MCO, is a medical cost containment company based in Morris Plains, New Jersey, founded in 1979. It runs a proprietary PPO provider network and provides case management, bill review and utilization review for workers' compensation claims, auto injury claims and group health programs.

Its clients are insurers, insurance funds, third-party administrators and self-insured employers, so the paying party behind a First MCO card is the underlying plan or claim.

Private Insurance Acceptedhttps://rehabseekers.com/insurance-accepted/private-insurance-accepted/

Is First MCO a health insurance company?

No, First MCO sells managed care and cost containment services rather than insurance policies. It does not pay claims or set benefits. The insurer, insurance fund, third-party administrator or self-insured employer that hires it decides what treatment is covered, what you owe and which levels of care are authorized.

If a treatment center mentions First MCO, ask which plan or claim the coverage sits behind before you start admission paperwork.

Private Insurance Acceptedhttps://rehabseekers.com/insurance-accepted/private-insurance-accepted/

Does First Managed Care Option cover drug and alcohol rehab?

Not by itself. First MCO is a cost containment vendor, so coverage for substance use treatment comes from the underlying arrangement: an employer group health plan, a workers' compensation claim or an auto injury claim. The company publishes nothing about addiction treatment benefits or levels of care.

Call the member line on your insurance card, or the claims adjuster handling your case, and ask what the plan will authorize.

Private Insurance Acceptedhttps://rehabseekers.com/insurance-accepted/private-insurance-accepted/

Does First MCO cover detox?

No detox benefit is described anywhere by First MCO. Whether medical detox is paid for depends on the plan renting its network, or on whether the care is tied to a covered workers' compensation or auto injury claim. Group health members should ask about the plan's behavioral health benefit.

Setting matters too, since hospital-based, residential and outpatient detox are authorized differently by most plan administrators.

Detox Centershttps://rehabseekers.com/programs/detox-centers/

Does First MCO cover inpatient rehab?

No, inpatient addiction treatment is not something First MCO administers. Its networks cover injury-related care, so residential or hospital rehab would be authorized by the group health plan, workers' compensation carrier or auto insurer standing behind the claim.

First MCO's utilization review work coordinates independent medical evaluations and peer reviews on injury claims, with evaluation reports issued within 24 hours of the exam.

Inpatient Rehabhttps://rehabseekers.com/programs/inpatient/

Does First MCO cover mental health treatment?

No behavioral health, psychiatry or counseling network is published by First MCO. Its specialty and ancillary networks list physical and occupational therapy, diagnostic imaging, durable medical equipment, home health, transportation, translation and pharmacy. Mental health coverage for a group health member is handled by the employer plan or its administrator.

The company names no behavioral health vendor, so ask the plan which organization manages its mental health benefit.

Counseling and Therapyhttps://rehabseekers.com/therapies/counseling-and-therapy/

Is First MCO a PPO?

Yes, First MCO runs a proprietary PPO network with access to more than 29,000 medical and hospital providers at pre-negotiated rates. The network is built around workers' compensation and auto injury care, and the company also works with national workers' compensation PPO networks as intermediary partners.

Providers are credentialed and re-credentialed every two years, and the company's network page cites 72 percent average savings for payers.

Private Insurance Acceptedhttps://rehabseekers.com/insurance-accepted/private-insurance-accepted/

What states does First MCO operate in?

First MCO is headquartered in Morris Plains, New Jersey, with a branch office in Fort Washington, Pennsylvania. Provider recruiting centers on New Jersey and surrounding jurisdictions, while wider geographic reach comes through national PPO partner networks. New Jersey is where its workers' compensation and auto injury work is concentrated.

In New Jersey it has been one of four Medical Review Organizations since 1995, with a decision point review plan on file with the state Department of Banking and Insurance.

Does First MCO require prior authorization?

Yes, for New Jersey auto injury claims First MCO has performed decision point review and pre-certification since 1998 under a plan on file with the New Jersey Department of Banking and Insurance. For workers' compensation it performs utilization review using independent medical evaluations and peer reviews.

No addiction-specific pre-certification rules or clinical criteria are published, so authorization steps for rehab come from the plan paying the claim.

Private Insurance Acceptedhttps://rehabseekers.com/insurance-accepted/private-insurance-accepted/

Does First MCO cover Suboxone or methadone?

No, those medications are not named in First MCO's pharmacy program, which serves workers' compensation and auto injury claims through SmithRx discounts and a targeted formulary. Pain medications usually clear without delay, while non-formulary drugs such as OxyContin and Valium need the claims adjuster's sign-off.

Prescription fills are monitored to see that drugs are injury-related, and nurse support for pharmacy requests is available around the clock.

Suboxone and Buprenorphinehttps://rehabseekers.com/medications/mat/buprenorphine/

What is the First MCO phone number?

First MCO's toll-free line is 1-800-831-9531, listed as available 24/7. The New Jersey headquarters in Morris Plains answers at 973-257-5200, the Fort Washington, Pennsylvania branch at 800-247-3422, and the fax number is 973-257-2288. Email reaches the company at info@firstmco.com.

Office hours shown on the company's home page are Monday to Friday, 8 a.m. to 4 p.m.

How do I find a provider that takes First MCO?

Use the WebMCO provider lookup at lookup.firstmco.com, which now opens a login page, or ask the party handling your claim for the network list. Injured workers in New Jersey whose employer uses First MCO can also request the posted panel physicians list from the employer.

For addiction treatment, ask the program's admissions staff and the plan administrator whether the care would be billed through the First MCO network at all.

Private Insurance Acceptedhttps://rehabseekers.com/insurance-accepted/private-insurance-accepted/

Is First MCO the same as First Health?

No, they are separate organizations. The First Health Network is a national PPO network, while First MCO is a New Jersey-based managed care and cost containment company serving workers' compensation carriers, auto insurers and group health payers. First Choice of the Midwest is another similarly named but unrelated PPO network.

Private Insurance Acceptedhttps://rehabseekers.com/insurance-accepted/private-insurance-accepted/

Is First MCO a Medicaid plan?

No, despite the letters MCO in its short name, the company has no Medicaid, CHIP or Medicare Advantage product and is not a Medicaid managed care organization. It serves workers' compensation carriers, auto insurers, insurance funds, third-party administrators and self-insured employers buying network access and cost containment.

If treatment needs to be paid by Medicaid, look for programs that bill your state's Medicaid program directly.

Medicaid Rehabhttps://rehabseekers.com/insurance-accepted/medicaid/

Does First MCO set my copay for treatment?

No, member cost sharing is neither published nor set by First MCO. Copays, deductibles and coinsurance come from the client's plan, while First MCO's pricing work is the pre-negotiated provider rates it arranges for payers and the bill review it performs on their behalf.

Ask the plan administrator for a benefit summary, and ask the treatment program for its self-pay rate as a comparison.

Self Pay Rehabhttps://rehabseekers.com/payment/self-pay/

Do you run a treatment service?

Get Verified to rank above unverified listings, show the Verified badge and be contacted directly.

Or claim or add your listing for free.

First Managed Care Option, Inc., branded First MCO or FMCO, is not an insurance company. It is a medical cost containment firm in Morris Plains, New Jersey, founded in 1979, that runs a proprietary PPO network and sells case management, medical bill review and utilization review to insurers, insurance funds, third-party administrators and self-insured employers. When that name turns up on an admission form, the organization paying the bill is the client behind it.

That distinction decides the whole question of treatment coverage. First MCO publishes no substance use benefit, no detox or residential rules and no behavioral health network, because it does not set benefits and does not pay claims. Coverage for addiction treatment comes from the underlying arrangement: a workers’ compensation claim, an auto injury claim under New Jersey personal injury protection, or an employer group health plan that rents the network.

The company works from a New Jersey headquarters with a branch office in Fort Washington, Pennsylvania, and reaches further through intermediary PPO partners. This guide covers what the name means for treatment, which door a claim travels through, how its review and pre-certification work, what the pharmacy program does and does not say, and how to find a program when First MCO is listed as the network.

Does First Managed Care Option Cover Drug and Alcohol Rehab?

First MCO does not decide that. It is a cost containment vendor and PPO network, not a payer, and none of its published material mentions substance use treatment, detox, residential care, partial hospitalization or intensive outpatient. Whether rehab is paid for depends on the plan or claim behind the name, and that is where the question belongs.

The company’s own use of the word rehabilitation points at injury care: return-to-work case management and networks for physical and occupational therapy, diagnostic imaging, durable medical equipment, home health, transportation, translation and pharmacy. No behavioral health, counseling or addiction treatment network is listed among those specialty and ancillary lines.

Which door is the claim using? Workers’ compensation, where First MCO handles intake, triage, case management and bill review for the carrier or fund; auto injury under New Jersey PIP, where it runs decision point review and a voluntary discount network; or group health, where an employer plan uses the network and its own administrator sets the benefit. The answer changes who authorizes treatment and who to call first.

Who Decides Each Level of Care?

The underlying plan document or claim file does. First MCO reviews medical necessity and level of care on behalf of the client, but the benefit itself, including day limits, network rules and cost sharing, is written by the insurer, fund or employer plan. Ask the plan administrator or the adjuster to put the covered levels of care in writing before an admission date is set.

Medical Detox

No detox rules are published by First MCO. Where withdrawal is physically dangerous, as it can be with alcohol and benzodiazepines, an emergency department is the right destination regardless of which network is on the paperwork. For a planned admission, ask the plan whether medical detox is a covered benefit and whether a review is needed before the first night.

Residential and Inpatient

A residential rehab stay is usually the level most tightly reviewed by any plan, with an initial authorization followed by continued stay reviews. Since First MCO names no clinical criteria of its own, the questions to ask are which criteria set the reviewer applies, how long the first authorization runs, and who files the request, the admissions team or the case manager.

PHP, IOP and Outpatient

Step-down care is where a group health plan is likeliest to pay without a long review. Partial hospitalization and intensive outpatient sit between a hospital bed and weekly sessions, and outpatient rehab with medication management is the most accessible level. Counseling benefits under a workers’ compensation or auto claim are tied to the injury, which is a narrower test than a health plan applies.

Does First MCO Need Prior Authorization for Rehab?

For New Jersey auto injury claims, yes: First MCO has run decision point review and pre-certification since 1998 under a plan on file with the New Jersey Department of Banking and Insurance. For workers’ compensation it performs utilization review. For addiction treatment specifically, no pre-certification rules are published, so the requirement comes from the client plan.

Reviews are staffed by nurse reviewers with medical director oversight on a paperless system, and the company says it has been one of only four Medical Review Organizations in New Jersey since 1995, with case managers assessing treatment plans for medical necessity and level of care under the state’s automobile insurance cost reduction framework. Utilization review on the workers’ compensation side coordinates independent medical evaluations, peer reviews and diagnostic evaluations, with evaluation reports issued within 24 hours of the exam.

What Clinical Criteria Are Used?

None are named. No First MCO page identifies a criteria set for medical necessity decisions, and nothing addiction-specific is published at all. That is a question worth asking in writing, along with the appeal route, because a treatment plan for a residential stay is a poor moment to discover which standard a reviewer is reading from.

Four questions before an admission date is set

Which plan or claim is paying, and who is the administrator or adjuster?

Is substance use treatment a covered benefit under that plan or claim at all?

Does detox, residential, PHP or IOP need a review before admission, and who files it?

Is the program contracted in the First MCO network, and what applies if it is not?

How Much Does Rehab Cost With First MCO?

First MCO publishes no member cost sharing, because it writes none. Copays, deductibles and coinsurance come from the client plan, and the company’s pricing is the pre-negotiated provider rate it arranges for the payer, with its network page citing a 72% average saving. Out-of-network bill negotiation is offered to clients rather than as a benefit a member can rely on.

Under a workers’ compensation or auto injury claim, the injured worker or claimant is generally not billed for care tied to the claim, which shifts the whole argument onto whether the treatment is accepted as claim-related. Under a group health plan using the network, the deductible and out-of-pocket maximum printed in that plan’s summary are the numbers that matter.

Typical US market rates before insurance
Level of care	Monthly	Daily
Medical detox (7–14 days)	$1,500 – $5,200 per week	$215 – $745
Residential inpatient	$6,200 – $26,000	$205 – $865
PHP	$7,200 – $14,000	$240 – $465
IOP	$2,700 – $9,200	$90 – $305
Outpatient	$1,300 – $5,200	$45 – $175

Those are the sums a program would bill with no coverage behind it. Where the plan behind the name turns out not to pay for addiction treatment, sliding scale rehab and self pay rehab are the routes that stay open while the question is settled.

Does First MCO Cover Suboxone, Methadone and Other Addiction Medication?

Its published pharmacy program does not mention them. The workers’ compensation and auto pharmacy benefit, run with discounts from SmithRx, uses a targeted formulary in which most pain medications are released without delay and non-formulary drugs, with OxyContin and Valium given as examples, need the adjuster to sign off. Buprenorphine, naltrexone and methadone are not named anywhere.

Where the Question Should Go

Because the formulary is built around injury-related prescribing, a request for medication assisted treatment is settled by the plan or claim rather than by the network. For group health, the employer plan’s pharmacy benefit manager holds the drug list. Ask where Suboxone and buprenorphine sit on that list before discharge from any inpatient setting.

Dosing Inside a Program

Medication dispensed inside a licensed opioid treatment program is billed as a program service rather than a pharmacy fill, which is why a methadone clinic is authorized differently from a retail prescription. First MCO monitors prescription fills to establish that drugs are injury-related and offers 24/7 nurse support for pharmacy requests on claims it manages.

Which Rehab Centers Are In-Network With First Managed Care Option?

A provider is in network when it holds a direct contract at pre-negotiated rates in the First MCO PPO, which covers over 29,000 medical and hospital providers across its workers’ compensation, auto injury and specialty lines. Credentialing is repeated every two years. Network status is settled through the WebMCO provider lookup, now behind a login, or with the adjuster or plan administrator.

Programs that accept First Managed Care Option are gathered on the First Managed Care Option page, with level-of-care pages for detox centers, inpatient rehab and private insurance accepted. Each listing shows the payments the program says it accepts, its licensing and accreditation, and how far it sits from the nearest airport, so a shortlist can be drawn up before the call that settles network status.

How Do I Find a Rehab That Takes First MCO?

Start with the toll-free line, 1-800-831-9531, listed as staffed 24 hours, or the Morris Plains headquarters on 973-257-5200; the Fort Washington branch is on 800-247-3422 and email goes to info@firstmco.com. Office hours are Monday to Friday, 8 a.m. to 4 p.m. Ask which client plan or claim the network is attached to, then take the coverage question there.

An injured worker in New Jersey may also be pointed to a posted panel of physicians by the employer, since carriers such as Tokio Marine America have named First MCO as their state-certified workers’ compensation health care network. Hospital systems list the name under their own accepted-plan tables; Cooper Norcross Health in Camden shows First MCO under group health and workers’ compensation, with Cooper Care Alliance excluded.

Is First MCO the Same as First Health or a Medicaid Plan?

No on both counts. The First Health Network is a separate national PPO, and First Choice of the Midwest is another unrelated network. Despite the letters in its short name, First MCO sells no Medicaid, CHIP or Medicare Advantage product and is not a Medicaid managed care organization. It holds URAC accreditation and ISO 27001 certification, and is led by president and chief operating officer Bruce Nash.

Before calling a program: have the claim number or plan name, the administrator’s phone number and the name of the insurer or employer behind the network. A program’s admissions team can check benefits far faster with those three items than with the words First MCO alone.

References and Citations

First Managed Care Option, Inc. — company, network, workers’ compensation, auto injury, managed care review, pharmacy and contact pages, 2026.
United States Patent and Trademark Office — trademark filings for First Managed Care Option, Inc., First MCO, FMCO and WebMCO, 2020 to 2021.
Cooper Norcross Health — accepted plan listing showing First MCO under group health and workers’ compensation.
Tokio Marine America — New Jersey workers’ compensation instructions naming First MCO as its state-certified health care network.
eWellness Healthcare Corporation — September 2018 announcement of the PHZIO TeleRehab cooperation agreement with First MCO.
RehabSeekers directory listings and market rate research, United States, 2026. Ranges are indicative and vary by program, length of stay and coverage.