Psychiatric Cpt Codes And Modifiers
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Psychiatric Cpt Codes And Modifiers

Multiagencyhipaacodesrev605
NM Behavioral Health Design Service List By HIPAA Code and Definition Current Procedural Terminology (CPT)

2004 American Medical Association.

All Rights Reserved.

No fee schedules, basic units, relative values, or related listings are CPT/ HCPCS/ Revenue Codes

Modifiers Service Definition Unit

Comments

CPT Codes

90801

H9,TR, HA Psychiatric diagnostic interview examination

Product/Hourly Authorized practitioners: Licensed Psychologist, Licensed or board-eligible Psychiatrist, Clinical Psychiatric Nurse Specialist, Licensed Independent Social Worker (LISW), Licensed Professional Clinical Mental Health Counselor (LPCC), Licensed Marriage & Family Therapist (LMFT).

DOH will use this code for commitment-related evaluations only.

CYFD will use this code only for a diagnostic exam.

Use HA modifier.For HSD/Medicaid Psychosocial Rehabilitation Program (PSR), use H0031 for assessment.For court-ordered exam, use modifier H9.

For HSD/Medicaid, Practitioner Type will determine rate.Note:

HSD/Medicaid pays based on practitioner and on an hourly rate; DOH and CYFD pay per product.

Page 1 of 38 Revised 6/24/05 Some services may not be funded by all agencies.

Please reference each agency’s crosswalk.

Practitioners must adhere to all licensing requirements and/or agency specific qualifications NM Behavioral Health Design Service List By HIPAA Code and Definition Current Procedural Terminology (CPT)

2004 American Medical Association.

All Rights Reserved.

No fee schedules, basic units, relative values, or related listings are included in CPT.

The AMA assumes no liability for the data contained herein.

Applicable FARS/DFARS restrictions apply to government use.

CPT/ HCPCS/ Revenue Codes

Modifiers Service Definition Unit

Comments 90802

H9,TR Interactive psychiatric diagnostic interview examination using play equipment, physical devices, language interpreter, or other mechanisms of communication.

Product/ Hourly Authorized practitioners: Licensed Psychologist, Licensed or board-eligible Psychiatrist, Clinical Psychiatric Nurse Specialist, LISW, LPCC, LMFT.

Special Instructions: For court-ordered, use modifier H9.For DOH school-based, use modifier TR.

For HSD/Medicaid, Practitioner Type will determine rate.Note:

HSD/Medicaid pays based on practitioner and on an hourly rate.

90804-90815

TR, U8, HA Individual psychotherapy, office (90804 for 20-30 min, 90806 for 45-50min, 90808 for 75-80 min) Face-to-face interactive interventions are focused and are designed to improve functioning and increase are relevant to the needs of the recipient and relate directly to the individualized goals and objectives specified in the recipient’s treatment plan.

This service includes individual (child or adult), family, and group counseling.

Individual psychotherapy, office with medical evaluation and management services (E/M), 90805 for 20-30 min, 90807 for 45-50 min, 90809 for 75-80 min) Psychotherapy is the treatment for mental illness and behavioral disturbances in which the clinician establishes a professional contact with the individual and, through definitive therapeutic communication, attempts to alleviate the emotional disturbances, reverse or change maladaptive patterns of behavior, and encourage personality growth and development.

90804-90809 Insight Oriented, Behavior Modifying and/or Supportive Psychotherapy refers to the development of insight or affective understanding, the CPT defined time

Authorized practitioners for even numbered services: Licensed Psychologist, Psychologist Associate licensed at the master’s level, Licensed or board-eligible Psychiatrist, Clinical Psychiatric Nurse Specialist, LISW, LPCC, LMFT, Licensed Professional Art Therapist (LPAT), Licensed Alcohol & Drug Abuse Counselor (LADAC), Registered or Licensed Mental Health Counselor (RMHC/LMHC), Licensed Professional Mental Health Counselor (LPC), or Licensed Masters Social Worker (LMSW).

Authorized practitioners for odd numbered services:

Page 2 of 38 Revised 6/24/05 Some services may not be funded by all agencies.

Please reference each agency’s crosswalk.

Practitioners must adhere to all licensing requirements and/or agency specific qualifications NM Behavioral Health Design Service List By HIPAA Code and Definition Current Procedural Terminology (CPT)

2004 American Medical Association.

All Rights Reserved.

No fee schedules, basic units, relative values, or related listings are included in CPT.The AMA assumes no liability for the data contained herein.

Applicable FARS/DFARS restrictions apply to government use.CPT/ HCPCS/ Revenue Codes

Modifiers Service Definition Unit

Comments use of behavior modification techniques, the use of supportive interactions, the use of cognitive discussion of reality, or any combination of the above to provide therapeutic change.

Individual psychotherapy is divided into two broad categories: 1) Insight Oriented, Behavior Modifying and/or Supportive Psychotherapy, and 2) Interactive Psychotherapy.

Individual psychotherapy, interactive, office, (90810 for 20-30 min, 90812 for 45-50 min, 90814 for 75-80 min) Individual psychotherapy, interactive, office with medical evaluation and management services (E/M), (90811 for 20-30 min, 90813 for 45-50 min, 90815 for 75-80 min) Interactive Psychotherapy (90810-90815) is typically furnished to children
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It involves the use of physical aids and non-verbal communication to overcome barriers to therapeutic interaction between the clinician and an individual who has not yet developed, or has lost, either the expressive language communication skills to explain his/her symptoms and response to treatment, or the recept
Mhc app a codes modifiers
LOUISIANA MEDICAID PROGRAM
> CHAPTER 13:

MENTAL HEALTH CLINICS APPENDIX A:

CODES AND MODIFIERS
PAGE(S) 10
Page 1 of 10

Section 13.5 CODES AND MODIFIERS MHC Billable and Non-Billable Procedure Codes Service Ticket Service Code Service Type Authorized Disciplines (Codes) CPT/HCCPS Code 001 Consultation

Psychiatrist (01); physician(02) Licensed psychologist (03); associate to a psychologist (04); medical psychologist (16); licensed clinical social worker (05);

registered social worker (29); graduate social worker(30); licensed professional counselor (15); professional counselor (33); licensed professional counselor intern (34); advanced practice registered nurse (17); physicians assistant (19); medical resident (20); medical intern (21); licensed marriage and family therapist (35); licensed marriage and family therapist intern (36) Not Medicaid Billable 002 Individual Screening

(Evaluation and management of a new patient) Psychiatrist (01); physician(02); advanced practice registered nurse (17); physicians assistant (19); medical resident (20); medical intern (21) 99201 15 99202 =15 and 30 min 99203 =30 and 45 min 99204 =45 and 60 min 99205

= 60 min

(Mental Health Assessment by non-physician) Licensed psychologist (03); associate to a psychologist (04); medical psychologist (16); licensed clinical social worker (05);

registered social worker (29); graduate social worker(30); licensed professional counselor (15); professional counselor (33); licensed professional counselor intern (34; licensed marriage and family therapist (35); licensed marriage and family therapist intern (36) H0031

LOUISIANA MEDICAID PROGRAM
> CHAPTER 13:

MENTAL HEALTH CLINICS APPENDIX A:

CODES AND MODIFIERS
PAGE(S) 10
Page 2 of 10

Section 13.5 Service Ticket Service Code Service Type Authorized Disciplines (Codes) CPT/HCCPS Code 003 Group Screening

Psychiatrist (01); physician(02) Licensed psychologist (03); associate to a psychologist (04); medical psychologist (16); licensed clinical social worker (05);

registered social worker (29); graduate social worker(30); licensed professional counselor (15); professional counselor (33); licensed professional counselor intern (34); advanced practice registered nurse (17); physicians assistant (19); medical resident (20); medical intern (21); licensed marriage and family therapist (35); licensed marriage and family therapist intern (36) Not Medicaid billable 004 Collateral Counseling/ Consult (Interpretation or explanation of results of psychiatric, other medical examinations and procedures, or other accumulated data to family or other responsible persons or advising them how to assist patient) Psychiatrist (01); physician(02); licensed psychologist (03); associate to a psychologist (04); medical psychologist (16); licensed clinical social worker (05);

registered social worker (29); graduate social worker(30); licensed professional counselor (15); professional counselor (33); licensed professional counselor intern (34); advanced practice registered nurse (17); physicians assistant (19); medical resident (20); medical intern (21); licensed marriage and family therapist (35); licensed marriage and family therapist intern (36) 90887 LOUISIANA MEDICAID PROGRAM
> CHAPTER 13:

MENTAL HEALTH CLINICS APPENDIX A:

CODES AND MODIFIERS
PAGE(S) 10
Page 3 of 10

Section 13.5 Service Ticket Service Code Service Type Authorized Disciplines (Codes) CPT/HCCPS Code 005 Psychosocial Evaluation Psychiatrist (01); physician(02); licensed psychologist (03); associate to a psychologist (04); medical psychologist (16); licensed clinical social worker (05);

registered social worker (29); graduate social worker(30); licensed professional counselor (15); professional counselor (33); licensed professional counselor intern (34); advanced practice registered nurse (17); physicians assistant (19); medical resident (20); medical intern (21); licensed marriage and family therapist (35); licensed marriage and family therapist intern (36) 90801 90802 (interactive)* 006 Psychiatric Evaluation Psychiatrist (01); physician (02) 90801 90802 (interactive)* 007 Psychological Testing (formerly Psychological Evaluation) Licensed psychologist (03); associate to a psychologist (04)medical psychologist (16)

96101 008

Medical Evaluation (and Management of an established patient) Psychiatrist (01); physician (02); advanced practice registered nurse (17); physicians assistant (19); medical resident (20); medical intern (21) 99212 15 min 99213 =15 and 30 min 99214 =30 and 44 min 99215 = 44 min 009

Other Evaluation/ Assessment

Not Medicaid billable 010 Psychological Evaluation Licensed psychologist (03); associate to a psychologist (04); medical psychologist (16) 90801 LOUISIANA MEDICAID PROGRAM
> CHAPTER 13:

MENTAL HEALTH CLINICS APPENDIX A:

CODES AND MODIFIERS
PAGE(S) 10
Page 4 of 10

Section 13.5 Service Ticket Service Code Service Type Authorized Disciplines (Codes) CPT/HCCPS Code 015 Individual Therapy /Counseling Psychiatrist (01); physician (02); licensed psychologist (03); associate to a psychologist (04); medical psychologist (16); licensed clinical social worker (05);

registered social worker (29); graduate social worker(30); licensed professional counselor (15); professional counselor (33); licensed professional counselor intern (34); advanced practice registered nurse (17); physicians assistant (19); medical resident (20); medical intern (21); licensed marriage and family therapist (35); licensed marriage and family therapist intern (36)

9080431 min 90806=31 and 61 min 90808=61 min Interactive*9081031 min 90812=31 and 61 min 90814=61 min 016 Group Therapy /Counseling Psychiatrist (01); physician (02); licensed psychologist (03); associate to a psychologist (04); medical psychologi
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