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Community Behavioral Health Providers - Supervisor Pricing Changes Begin July 1 [Corrected Date]

Client Alert

Effective July 1 [corrected date], community behavioral health providers wishing to receive reimbursement at the supervisor rate must add the HP or HT Modifier to fee-for-service (FFS) claims. An HP Modifier needs to be added for services provided by a supervised trainee/assistant under supervision of an MD/DO, PSY, CNS, CNP, or PA. An HT Modifier needs to be added for services provided by a supervised trainee/assistant under supervision of an LISW, LIMFT, LPCC, LICDC (SUD only), Lic school PSY, LSW, LMFT, LPC, LCDC III (SUD only), and LCDC II (SUD only).

Supervisor pricing is allowed for the following service codes:

Code

Description

90785

Interactive Complexity

90791

Psychiatric Diagnostic Evaluation w/o Medical

90832

Individual Psychotherapy – 30 minutes

90834

Individual Psychotherapy – 45 minutes

90837

Individual Psychotherapy – 60 minutes

90839

Psychotherapy for Crisis – first 60 minutes

+90840

Psychotherapy for Crisis – additional 30 minutes

90846

Family Psychotherapy w/o Patient – 50 minutes

90847

Family Psychotherapy w/Patient present – 50 minutes

90849

Multiple-family Group Psychotherapy

90853

Group Psychotherapy (not multiple family group)

99406

Smoking and Tobacco Use Cessation Counseling – Intermediate: greater than 3 minutes and up to 10 minutes

99407

Smoking and Tobacco Use Cessation Counseling – Intensive: greater than 10 minutes

Providers do not need to resubmit claims that were submitted prior to or on June 30 [corrected date].

Please contact BMD Healthcare Member Daphne Kackloudis at dlkackloudis@bmdllc.com or Attorney Jordan Burdick at jaburdick@bmdllc.com with any questions you may have regarding the implementation of these new guidelines.


New Florida Law: Patient Overpayments Must Be Refunded Within 30 Days

Effective January 1, 2026, Florida Senate Bill 1808 requires health care facilities and practitioners to refund patient overpayments within 30 days after an overpayment is identified. The law applies to overpayments tied to claims submitted to government programs or private insurers and introduces fines and disciplinary consequences for noncompliance. Providers should review billing and payment practices now to prepare for the new requirements.

USCIS Policy Change Impacting Work Authorization: Advisory for Employers and Human Resources

USCIS has issued a policy memorandum pausing immigration benefit processing for individuals from 19 high-risk countries and requiring a re-review of certain previously approved cases. This change may affect work authorization, employment verification, and workforce stability. Employers and HR teams should review impacted employees and update compliance procedures.

CMS Releases CY 2026 Medicare Physician Fee Schedule Final Rule with Key Payment and Telehealth Updates

CMS issued the CY 2026 Medicare Physician Fee Schedule Final Rule on October 31, 2025, with changes effective January 1, 2026. The Final Rule includes increases to the conversion factor, a new efficiency adjustment, updates to practice expense methodology, permanent telehealth policy changes, revised payment for skin substitutes, expanded rules for Part B drugs and biologicals, enhanced policies for Rural Health Clinics and Federally Qualified Health Centers, and new care management and behavioral health services.

Ohio Department of Medicaid Updates: Key Changes to Physician Reimbursement Rates in Early Parenthood

The Ohio Department of Medicaid has proposed amending Ohio Administrative Code Rule related to covered Medicaid reimbursements for physicians. Beginning on January 1, 2026, they are proposing an increase to rates for prenatal care, childbirth, and infant care and provider visits.

Name, Image, and Likeness Agreements in Healthcare

For example, some healthcare providers have begun to utilize "Name, Image, and Likeness" agreements to promote the brand they have created through their healthcare practice.  We have seen the most healthcare NIL activity with longevity and wellness providers, as well as orthopedics.