May 22, 2020

State of Alabama
Press Release: Medicaid

Alabama Medicaid Extends Additional Behavioral Health Procedure Code Coverage via Telemedicine


 
<<<<NOTE: This ALERT is a follow-up to the ALERT dated March 18, 2020>>>>

 

 TO:        Psychologists, Licensed Counselors, Licensed Marriage and Family Therapists and Licensed

   (clinical) Social Workers

 

As Medicaid continues to monitor the outbreak of the Coronavirus Disease 2019 (COVID-19) in Alabama, we are updating the procedure codes which may be billed via telemedicine to include the following:

 

  • 90791

Psychiatric diagnostic evaluation

 

  • 96130, 96131, 96136, 96137, 96138, 96139 

Psychological testing evaluation services by physician or other qualified health care professional,

including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report and interactive feedback to the patient, family member(s) or caregiver(s), and test administration and scoring by technician

 

·         96116, 96121, 96132, 96133,

Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report and interactive feedback to the patient, family member(s) or caregiver(s), and test administration and scoring by technician

 

·         96146

Psychological or neuropsychological test administration, with single automated instrument via electronic platform, with automated result

 

The effective dates for this Alert are March 16, 2020 - June 30, 2020, or at the conclusion of the COVID-19 National emergency, whichever occurs first. Providers can begin submitting claims on May 21, 2020.

 

During the COVID-19 emergency, it is important to file claims as quickly as possible to ensure payment from Medicaid is made to Medicaid providers close to the date of service. For Medicaid to ensure proper reporting with the Centers for Medicare and Medicaid Services (CMS), it is necessary to file the claim with place of service ‘02’ (telemedicine) and a modifier of ‘CR’ for catastrophic/disaster to assist with claims tracking.

 

Alabama Medicaid will review and verify that requirements for the extension of telemedicine services are being met. Documentation requirements can be found here:  https://medicaid.alabama.gov/documents/4.0_Programs/4.2_Medical_Services/4.2.6_Mental_Health/4.2.6_Temporary_Telemedicine_Services_Testing_Codes_5-21-20.pdf. Payments to providers that do not meet the specifications are subject to recoupment. 

 

If you have questions, please visit the Medicaid website at www.medicaid.alabama.gov, or call the Medicaid Fiscal Agent at 1.800.688.7989.

 

Contacts:

karen.watkins-smith@medicaid.alabama.gov,

stephanie.logan@medicaid.alabama.gov,

beverly.churchwell@medicaid.alabama.gov




  • For more information, visit http://medicaid.alabama.gov
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