Empire BCBS will begin managing behavioral health services through Carelon

If you are a participating BCBS provider, your contract will be merged with Carelon (ie you will now be a participating provider with Carelon for BCBS clients.)  Get more information at:  https://providernews.empireblue.com/article/notice-of-assignment-of-your-empire-provider-agreement-to-beacon

NYS Medicaid approves credentialing for LCSWs, LMHCs and LMFTs

NYS Medicaid has approved credentialing for LCSW, LMHCs and LMFTs.  This will enable NYS providers to be reimbursed for services when patients are covered through Medicare and Medicaid as a secondary or patients who only have Medicaid.   Below is the link to the provider manual.  Please contact T & T for credentialing assistance and fee schedule information at 888.364.3858 or info@ttmedbill.com

 https://www.emedny.org/ProviderManuals/LMHP/PDFS/LCSW_LMHC_LMFT_Policy_Manual.pdf

Medicare approves credentialing of LPCs, LMHCs and LMFTs

 On December 2022, Congress approved the Mental Health Access Improvement Act (S.828/

H.R.432) and was signed into law by President Biden. This bill allows LPCs, LMHCs and LMFTs to enroll as providers in the Centers for Medicare and Medicaid Services as Medicare providers.  Enrollment will begin January 2024.  Contact T & T Medical Billing for credentialing assistance 888.364.3858 or info@ttmedbill.com.

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.