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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.


Ohio Board of Pharmacy Update: Key Regulatory Changes and Proposals You Need to Know

The Ohio Board of Pharmacy (BOP) has rescinded certain OAC rules (OAC 4729:5-18-01 through 4729:5-18-06), removing regulations on office-based opioid treatment (OBOT) clinics. The rescissions took effect on June 3, 2024. The BOP also published a new rule, OAC 4729:8-5-01, which sets explicit reporting guidelines for licensed dispensaries and became effective on June 7, 2024.

LGBTQIA+ Patients and Discrimination in Healthcare

In early April, the Kaiser Family Foundation released a study outlining the challenges that LGBT adults face in the United States related to healthcare. According to the study, LGBT patients are “twice as likely as non-LGBT adults to report negative experiences while receiving health care in the last three years, including being treated unfairly or with disrespect (33% v. 15%) or having at least one of several other negative experiences with a provider (61% v. 31%), including a provider assuming something about them without asking, suggesting they were personally to blame for a health problem, ignoring a direct request or question, or refusing to prescribe needed pain medication.”

Ohio Recovery Housing Overhaul: New Standards and Certification Requirements Reshape Sober Living Spaces

Ensuring Fair Access: SB 269 Protects Affordable Medication for Low-Income Patients

SB 269, introduced on December 19, 2023, will ensure that 340B covered entities, including Federally Qualified Health Centers, Ryan White Clinics, disproportionate share hospitals, and Title X clinics, can acquire 340B drugs without facing undue restrictions or discriminatory practices from drug manufacturers and distributors. This protection is crucial for 340B covered entities to continue to provide affordable medications and comprehensive services to low-income patients.

Unveiling Ohio's Pharmacy Board Updates for Distributors, Mobile Clinics, and Controlled Substances

The Ohio Board of Pharmacy will hold a public hearing on May 28, 2024, to discuss several proposed changes and additions to Ohio Administrative Code (OAC). These changes pertain to terminal distributors of dangerous drugs (TDDDs), mobile clinics or medication units, and the classification of controlled substances.