Due to the COVID outbreak, Alliance Health is committed to providing financial support for our Medicaid funded Child Residential Services. The rates are specifically to support direct care staff and families, increased expenses to meet children’s’ education and nutrition needs during extended school closure and COVID related supplies. Each level of service has a Scope of Work to clarify those expectations.
Alliance is extending the date of the rate enhancement thru June 30, 2020 for the Child MH/SUD Residential and PRTF services. The table below outlines the rate increase per level of care along with the associated procedure codes.
|Level of Care||Procedure Code||COVID 90 Day Rate Increase|
|PRTF||RC 911||15%(based on provider rate)|
|Therapeutic Foster Care, IAFT, Enhanced TFC, IDD/MH TFC||S5145|
S5145 22 HA
|Level III & IV||H0019 HK|
|Rapid Response||S5145 22 Z3||$260.00|
Important Information regarding State Funded Residential providers
Due to the COVID outbreak, Alliance Health is committed to providing financial support for our State Funded Residential Services. The rates are specifically to support direct care staff and increased facility related costs due to COVID. These rates are in effect from June 1-June 30, 2020.
There are some State Funded specialized residential services that are not included in the grid below, but will be notified individually for their program specific enhanced rate. Individual agencies impacted by those exceptions will be notified by their Provider Network Development Specialist.
|Level of Care||Procedure Code||June Rate|
|Group Living High||YP780||$162.74|
|Group Living Moderate||YP770||$86.80|
|Group Living Low||YP760||$63.58|
|Family Living Low||YP740||$57.50|
|Supervised Living Low||YP710||$33.26|
Update on Telephonic Codes
The below telephonic codes will be extended through the conclusion of the State of Emergency related to COVID-19. Please note, Alliance is currently working through the setup of extending the below COVID-19 related codes and we will issue further guidance thru Provider News on when you can successfully submit billing, please continue to hold billing until this notice is issued.
|99441 CR||PHONE E/M PHYS/QHP 5-10 MI|
|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 MI|
|98968 CR||PHONE E/M NON-PHYS QHP 21-30 MIN|
|99446 CR||INTERPROFESSIONAL CONSULTATIONS QHP TO MD 5-10 MIN|
|99447 CR||INTERPROFESSIONAL CONSULTATIONS QHP TO MD 11-20 MIN|
|99448 CR||INTERPROFESSIONAL CONSULTATIONS QHP TO MD 21-30 MIN|
|99449 CR||INTERPROFESSIONAL CONSULTATIONS QHP TO MD 31 + MIN|
Important Information for Innovation, TBI and IDD Providers
The Division of Health Benefits (NC Medicaid) issued Special Bulletins COVID-19 #75 & 76 Behavioral Health Service Flexibilities– Innovations and TBI Waivers’ Appendix K and Developmental Disability State Funded Benefit Plans. Please note, Alliance is currently working through the setup of using COVID-19 related GT and CR modifiers and we will issue further clarification and guidance by the end of next week to identify effective date to submit billing using these modifiers.
Please direct any questions or concerns to: [email protected].
Alliance Health highly recommends that you monitor Provider News and our website daily for any updates regarding provider services. Alliance will update this information as we receive any updates from the State in regards to COVID-19.
Please continue to check our COVID-19 resources for providers at alliancehealthplan.org/providers/covid-19-updates-and-resources. Alliance will continue to update this page with resources.
In the event that COVID -19 seriously impacts your ability to provide services to our members, please notify Alliance immediately by submitting the Temporary Disruption of Service Delivery form found on our website.