TCM
CSA
THERAPY
PSS
BILLING GUIDELINES
100

HOW MANY CONTACTS SHOULD TCM'S BILL A MONTH

25

100

WHAT IS MONTHLY ENCOUNTER GOAL?

100

100

WHAT IS MONTHLY ENCOUNTER GOAL?

120

100

WHAT SERVICE CODE IS GROUP THERAPY?

091

100

CAN ANOTHER SERVICE HAPPEN WITH A COLLATERAL SERVICE?

NO

200

WHAT REQUIREMENT IS NEEDED FOR SUD CLIENTS TO GET TCM?

MODERATE-SEVERE DIAGNOSIS

200

what is the minimum length of time a CSA can bill for a service?

8 minutes

200

WHAT IS THE MAXIMUM LENGTH OF TIME THAT A CLIENT CAN RECIEVE SERVICES IN 1 DAY?

180 MINUTES/3 HOURS

300

WHAT REQUIREMENT IS NEEDED FOR SMI/SED CLIENT TO GET TCM?

LOCUS SCORE OF 3+

300

what insurance does not require an OTR?

Humana

300

Can a prescriber and a therapist for individual see a client on the same day?

No, cannot be reimbursed on the same day as individual therapy

400

CAN TCM BILLABLE SERVICE BE BILLED ON SAME DAY AS ANOTHER SERVICE?

YES

400

Can CSA be reimbursed on the same day at TR?

No

500

WHEN IS THE 1ST NEEDS ASSESSMENT DUE?

WITHIN 5 DAYS OF COGNITO REFERRAL

500

A client must have a primary  _______diagnosis to receive CSA services.

mental health

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