Cooks Children's Health Plan

 Effective 9/1/2022, Beacon will no longer manage the behavioral health services for Cooks Children's Health Plan.  Cooks Children's Health Plan will manage the behavioral health for CHIP and STAR members.  Providers will need to be credentialed with Cooks Children's Health Plan directly.  Call 800.964.2247 to be directed to provider relations.  For eligibility and claims questions after 9/1/2022, call 888.243.3312

Medicare may be approving a fee schedule for LMFTs, LPCs and LMHCs

The link below outlines what may be the upcoming approval of Medicare credentialing LMFTs, LMHCs and LPCs.  If that occurs, T & T can process applications for anyone interested and submit the billing..

https://telehealth.org/practice-alert-proposed-cms-reimbursement-for-lmfts-lpcs-addiction-counselors-psychologists-social-workers-others/?smclient=03d9c747-e7f8-11eb-83c8-18cf24ce389f

Looking to get credentialed with BCBS of Illinois?

BCBS of Illinois is making the credentialing process much easier during this COVID 19 crisis.  Visit the link below to see how to get started if you want to become paneled with this carrier.
https://www.bcbsil.com/provider/education/2020/2020_04_08.html

Billing for psychotherapy sessions via telehealth during COVID 19 crisis

Many questions have come up about how insurance companies want telehealth sessions billed.  Telehealth sessions are indicated with a modifier along side the regular psychotherapy CPT codes in box 24D of the CMS 1500 form.

All telehealth services are billed as place of service "02" in box 24B of the CMS 1500 form.  Medicare and Medicaid Connecticut do not require a modifier when billing telehealth services but you do have to bill with 02 place of service.  BUT Medicare will pay more if you bill it as POS 11 and 95 modifier.

The two modifiers you must use to indicate telehealth sessions were performed are:

GT: Via interactive audio and video telecommunication systems
95:  Synchronous telemedicine service rendered via a real-time interactive audio and video          telecommunications system

Below is a list of some popular companies and which modifier they prefer you use.

GT - Beacon, Quest, United, Aetna, BCBS NY, BCBS NJ, BCBS ILL, Highmark BCBS, Independence BCBS, Carefirst BCBS, GHI

95 - Cigna, BCBS TX, Healthfirst, Fidelis, BCBS VT.

These are just a handful of companies.  Feel free to reach out if you'd like additional information on more companies.

MVP no longer using Beacon Health Strategies

Beginning 1/1/2020, MVP will be managing it's behavioral health products in house and no longer using Beacon Health Strategies.  Call the number on the back on the MVP card to verify all outpatient mental health benefits and send all behavioral health claims directly to MVP

Optum/UBH fee increase

Many providers have been receiving letters from Optum/UBH network services indicating fee increases for many cpt codes.  If you have not received a letter by end of March 2019 contact Optum/UBH for a review of your contract fees.

Optum new 90837 policy

Effective 12/1/2018, Optum/UBH is no longer requiring preauthorization for the 60 minute therapy code 90837.