ccosta
Networker
Hello all,
I've been tasked to convert the current "H" & "T" HCPCS codes used by Medicaid for Behavioral Health services into Billable CPT codes for Medicare. Odd yes, however as a Medicare Advantage Organization that utilizes Risk Adjusted Codes (HCCs) [Diagnostic] for submission to CMS, and now with ACA plans utilizing Risk Adjusted Codes as well, the list used by Medicaid is NOT accepted by Medicare for submission.
I have crossed walked a good portion of them, yet they are some that I have yet to find a CPT code for, any help would be appreciated.
These are the tricky ones: In-depth assessment either new or established patient done by provider with a Bachelors or Master degree but not physician; Targeted Case Management for Children and Adults; Behavioral Services for a Day - Substance Abuse or Mental Health; Behavioral Health Medical Screening - Substance Abuse or Mental Health; Treatment Plan Development and Review - Substance Abuse or Mental Health; Bio-psychosocial Evaluation - Substance Abuse or Mental Health by provider with a Bachelors or Masters degree but not physician.
Any suggestions, help, or answers would be of great help. Project ends 3/18/2016.
Thank you,
Carl
I've been tasked to convert the current "H" & "T" HCPCS codes used by Medicaid for Behavioral Health services into Billable CPT codes for Medicare. Odd yes, however as a Medicare Advantage Organization that utilizes Risk Adjusted Codes (HCCs) [Diagnostic] for submission to CMS, and now with ACA plans utilizing Risk Adjusted Codes as well, the list used by Medicaid is NOT accepted by Medicare for submission.
I have crossed walked a good portion of them, yet they are some that I have yet to find a CPT code for, any help would be appreciated.
These are the tricky ones: In-depth assessment either new or established patient done by provider with a Bachelors or Master degree but not physician; Targeted Case Management for Children and Adults; Behavioral Services for a Day - Substance Abuse or Mental Health; Behavioral Health Medical Screening - Substance Abuse or Mental Health; Treatment Plan Development and Review - Substance Abuse or Mental Health; Bio-psychosocial Evaluation - Substance Abuse or Mental Health by provider with a Bachelors or Masters degree but not physician.
Any suggestions, help, or answers would be of great help. Project ends 3/18/2016.
Thank you,
Carl