On March 27, Alliance released a billing code table describing GT and CR modifiers for outpatient, E&M, RB-BHT and enhanced services provided by virtual and telephonic means during the COVID crisis. However, the coding system has not yet been standardized across the state and providers’, MCOs’ and the states billing system is not yet fully set up to receive these modifiers.
Therefore, to facilitate payment to providers and to allow Alliance and the state to monitor disruption in services, please submit any billing you may have been holding for dates of service from 3/10/2020 forward for services provided through telepsychiatry. Until further notice, billing should be submitted using the standard CPT and HCPCS codes without the telehealth modifier, using office as the place of service.
Services covered under this notice include Medicaid and State Funded:
Outpatient and Inpatient Assessment, Outpatient Therapy (Inclusive of TFCBT, DBT and PCIT) and Consultation Codes
Evaluation and Management (E&M) Codes
Research Based – Behavioral Health Treatment (RB-BHT) codes
ACTT, CST, Intensive In-Home, Family Centered Treatment (FCT) Peer Support, FCT, Mulltisystemic Therapy (MST), Intercept, and Mobile Crisis Management.
Although billing will be submitted with office as place of service, providers should document in the medical record how the service was provided, by telehealth or telephonically.
Please note the following telephonic only codes are currently set-up within both the State and Alliance system and should be billed using the CR modifier.
CPT Code Description
|99441||CR||PHONE E/M PHYS/QHP 5-10 MIN|
|99442||CR||PHONE E/M PHYS/QHP 11-20 MIN|
|99443||CR||PHONE E/M PHYS/QHP 21-30 MIN|
|98966||CR||PHONE E/M NON-PHYS QHP 5-10 MIN|
|98967||CR||PHONE E/M NON-PHYS QHP 11-20 MIN|
|98968||CR||PHONE E/M NON-PHYS QHP 21-30 MIN|