96153


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CODING AND BILLING GUIDELINES

96153 . Health and behavior intervention, each 15 minutes, face-to-face; group (2 or more patients) 96154 . Health and behavior intervention, each 15 minutes, face-to-face; family (with the patient present) Diagnoses that Support Medical Necessity. Medical diagnoses only . Reasons for Denial . 1. Beneficiaries who do not have specific underlining medical condition. 2. Services for preventive ... Pub on Tue, 14 Aug 2018 21:30:00 GMT
Source: https://downloads.cms.gov/medicare-coverage-database/lcd_attachments/30514_1/L30514_031610_cbg.pdf
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PSYCHOLOGICAL EVALUATION AND MANAGEMENT OF NON-MENTAL ...

96152-96153) may be considered reasonable and necessary for the member who meets all of the following criteria: 1. The member has an underlying physical illness or injury, and 2. There is reason to believe that a biopsychosocial factor may be significantly affecting the treatment, or medical management of an illness or an injury, and 3. The member is alert, oriented and has the capacity to ... Pub on Fri, 17 Aug 2018 11:18:00 GMT
Source: https://www.priorityhealth.com/provider/manual/auths/~/media/documents/medical-policies/91546.pdf
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CMS MANUAL SYSTEM

• Group MNT and HBAI services (CPT codes 97804, and 96153 and 96154, respectively); • Subsequent hospital care services, with the limitation of one telehealth visit every 3 days (CPT codes 99231, 99232, and 99233); and Pub on Thu, 16 Aug 2018 06:40:00 GMT
Source: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R140BP.pdf
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REVISED BEHAVIORAL HEALTH SPECIFIC BILLING GUIDELINES 2.12–

96153 Health and behavior intervention, each 15 minutes, face-to-face; group (2 or more patients). 96154 Health and behavior intervention, each 15 minutes, face-to-face; family (with the Pub on Thu, 16 Aug 2018 00:42:00 GMT
Source: https://www.bcbst.com/providers/behavioral_health/billing_guidelines.pdf
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HEALTH AND BEHAVIOR ASSESSMENT/INTERVENTION

Printer-Friendly Page Health and Behavior Assessment/Intervention EFFECTIVE DATE 01/24/2004 LAST UPDATED 12/02/2008 RELATED POLICIES Behavior Health Services Description: Health and behavior assessment procedures are used to identify the psychological, behavioral, Pub on Fri, 20 Jul 2018 21:09:00 GMT
Source: https://www.bcbsri.com/sites/default/files/polices/HealthandBehaviorAssessmentIntervention.pdf
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HEALTH AND BEHAVIOR ASSESSMENT & INTERVENTION

H&B Intervention – Individual or Group (CPT codes 96152 and 96153) o Specific psychological interventions and outcome goals have been clearly identified; and o The psychological interventions are necessary to address: Pub on Sun, 05 Aug 2018 17:16:00 GMT
Source: https://www.providerexpress.com/content/dam/ope-provexpr/us/pdfs/clinResourcesMain/guidelines/cdg/hba.pdf
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COMMUNITY HEALTH CENTER CPT CODE DIAGNOSTIC CODE MEDICARE ...

96153 UT Group TX 96154 UT Family TX w/ PT 96155 UT Family TX w/o PT Physicians, Psychologists and state licensed Master’s level clinicians All services billed by an independent mental health clinic or outpatient hospital program as mental health services provided by a psychiatrist or psychiatric APB shall be eligible for provision of telepsychiatry except for group therapy Yes Psychiatrist ... Pub on Wed, 01 Aug 2018 09:14:00 GMT
Source: https://www.integration.samhsa.gov/financing/New_Jersey_.pdf
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FAQS ON BILLING FOR HEALTH AND BEHAVIOR SERVICES

FAQs on Billing for Health and Behavior Services by Government Relations Staff January 29, 2009—Practicing psychologists are eligible to bill for applicable services and receive reimbursement from Pub on Tue, 14 Aug 2018 09:27:00 GMT
Source: http://my.fit.edu/~tharrell/cbhc/Billing%20&%20Reimbursement-National%20Health%20Service/FAQs%20on%20Billing%20for%20Health%20and%20Behavior%20Services%20APA.pdf
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HEALTH AND BEHAVIOR ASSESSMENT AND INTERVENTION TO BE A ...

Health and Behavior Assessment and Intervention to Be a Benefit of Texas Medicaid Information posted February 14, 2014 Effective for dates of service on or after April 1, 2014, health and behavior assessment Pub on Mon, 13 Aug 2018 09:49:00 GMT
Source: http://www.tmhp.com/News_Items/2014/02-Feb/02-14-14%20Health%20and%20Behavior%20Assessment%20and%20Intervention%20to%20Be%20a%20Benefit%20of%20Texas%20Medicaid.pdf
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NATIONAL CORRECT CODING INITIATIVE EDITS - CONTENT.CCRN.COM

Mutually Exclusive Edits Italicized Component Edits Bold National Correct Coding Initiative Edits Column 1 Codes Column 2 Codes With Modifier Status Of Pub on Wed, 15 Aug 2018 08:43:00 GMT
Source: http://content.ccrn.com/cce/pdf/conferences/rehabsummit/attendee_info/speaker_mats/olson_2008_rehab_ncci_list.pdf
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