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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.


Telemedicine Flexibilities Extended to March 31, 2025

The American Relief Act of 2025 extends key telehealth flexibilities through March 31, 2025, originally enacted during the COVID-19 Public Health Emergency (PHE). These flexibilities remove geographic and originating site restrictions for Medicare patients, expand the list of qualified practitioners, and allow for audio-only services and telehealth mental health care without in-person requirements. Although this extension is temporary, it provides continued access to essential healthcare services. Congress will need to pass permanent legislation to solidify these changes beyond March 2025.

Corporate Transparency Act Is Back in Effect: Are You Ready?

On December 23, 2024, the Fifth Circuit Court of Appeals reinstated the filing requirements under the Corporate Transparency Act (CTA), overturning a prior injunction. Businesses now have updated deadlines to file initial beneficial ownership information reports with the Financial Crimes Enforcement Network (FinCEN), based on their registration date. Affected companies must comply with these new deadlines, which vary depending on when the company was created or registered.

Checklist of Legal Considerations for a Med Spa

Checklist of key legal considerations for a med spa providing a broad overview of certain state and federal legal requirements.

Understanding Ohio House Bill 660: A Game-Changer for Student-Athletes

Ohio House Bill 660 is set to reshape Name, Image, and Likeness (NIL) agreements for student-athletes by allowing direct compensation from universities and providing greater financial opportunities while preserving amateur status. The bill simplifies the regulatory framework, introduces safeguards, and creates challenges and ethical considerations for stakeholders.

Effective December 12, 2024: Key Updates to Ohio Medicaid Rules for CPC and CMC Programs

Ohio Medicaid has amended rules for the Comprehensive Primary Care (CPC) and Comprehensive Maternal Care (CMC) programs, effective December 12, 2024. Key updates include expanded provider eligibility, stricter cultural competency training timelines, new clinical quality metrics, and changes to maternal care requirements.