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Billing Code Update for Services Provided through Telepsychiatry

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:

Telepsychiatry Codes

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

Enhanced Services

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.

Procedure Code

Mod

CPT Code Description

99441CRPHONE E/M PHYS/QHP 5-10 MIN
99442CRPHONE E/M PHYS/QHP 11-20 MIN
99443CRPHONE E/M PHYS/QHP 21-30 MIN
98966CRPHONE E/M NON-PHYS QHP 5-10 MIN
98967CRPHONE E/M NON-PHYS QHP 11-20 MIN
98968CRPHONE E/M NON-PHYS QHP 21-30 MIN


Page last modified: April 5, 2020