Billing Codes
The code you should bill if less than 3 group or day treatment clients show up.
What is group skills/group therapy/day treatment?
What is an addendum?
Psychoeducation can be billed on the same day as these two other types of therapy codes.
What are the diagnostic assessment and psychotherapy?
This must be completed BEFORE completing an ARMHS ITP.
What is the functional assessment?
The age of eligibility for billing Clinical Care Consultation.
The number of staff who can bill a CTSS skills group for 9 kids.
What is 2 staff?
Note: 3-8 kids- 1 staff; 9-12 kids- 2 staff. Cannot have more the 12 clients in a group.
These rules are the same for therapy groups
ARMHS groups- up to 2 staff can bill group for 2-10 clients. Cannot have more than 10 enrolled in a group.
What are:
1. Meet with the client/caregiver(s) to determine if the DA is still up to date and relevant.
2. Use clinical judgement to determine if you concur with the old diagnosis.
Medical necessity for Psychoeducation can be documented in one of these two documents.
What are the DA or the ITP?
These people are included in the treatment team for both children and adults.
Who are:
(including but not limited to) the client, guardians/support people, MHP, therapist, case manager, and/or med provider.
The list of people you may bill CCC with. (Name at least 3)
Who are:
Important Note: A therapist CANNOT bill CCC for talking to an MHP.
What is when you are providing two distinct services?
This is when you make a correction to a DA you recently completed. Examples include: fixing the F code, clarifying information from the client after the explanation of findings, redacting information prior to release.
What is an amendment?
(Get 3 our of 6 for full points)
What are:
-Type of services (individual, family, peer group, family group)
-Interventions used
-Number of attendees
-Roles of attendees
-Attendees responses to interventions
-Potential impact on eligible member
This code can only be used for treatment planning with children IF a treatment plan is eventually completed. It must be taken back if an ITP is never completed for that client.
What is H0032 treatment plan review and development?
These two factors determine which CCC code to use.
What are length of time and modality (face to face or by telephone)?
The code you bill when providing skills or therapy to a caregiver only. This code is NOT billed when casually chatting with a caregiver or giving an update on what you did at the end of a session.
What is Family skills/ Family psychotherapy without client present?
The scenarios when a DA update would be required. (get 3 our of 4 for full points)
What are
-significant changes that impacts the course of treatment
-changes in diagnosis
-client request
-client had a brief DA and needs additional services (more than 10 therapy sessions).
The different between psychoeducation and psychotherapy.
What is educating clients and caregivers about aspects of mental illness, treatment, and recovery vs. using therapeutic interventions to directly treat symptoms of mental illness?
The only CTSS statute requirements for these include:
They must be measureable
They must have a baseline
They must have a target success rate
What are goals and objectives?
There are no statutes that mandate HOW we can measure goals and objectives (i.e. by report or in session).
If this is true, two therapists at Fernbrook can bill CCC for consutlation
What is they work with the SAME client to provide a therapy service (i.e. day treatment and individual or individual and family, etc.)?
You cannot bill for consulting when two therapists work with two different siblings or clients who are otherwise related.
Ask yourself these three questions when "stacking" codes. (billing more than one code for the same client in a day).
What are:
Am I billing these codes separately because I provided separate services?
Am I billing these codes because it benefits me to do it this way?
Does the client benefit from theses two separate services?
If a service is recommended on the DA, this can be adjusted on the ITP without updating the DA.
What is increasing or decreasing necessary hours?
Psychoeducation CANNOT be billed for this general service.
What is parent education?
A therapist bills this code for initial treatment planning with an adult or child who is a NEW client between the time of DA completion and the time of the initial ITP being completed.
What is the Psychotherapy code?
CCC does not need to be recommended in the DA if medical necessity for CCC is determined in this document.
What is the ITP?