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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.


Governor Mike DeWine and The Ohio State University Introduce the SOAR Study on Ohio Mental Illness

On January 19, Ohio Gov. Mike DeWine and The Ohio State University announced a new research initiative, the State of Ohio Adversity and Resilience (“SOAR”) study, which will investigate all factors influencing Ohio’s mental illness and addiction epidemic.

CHANGING TIDES: Summary and Effects of Burnett et. al. v. National Ass’n of Realtors, et. al.

In April 2019, a class-action Complaint was filed in federal court for the Western District Court for Missouri arguing that the traditional payment agreements employed by many across the United States amounted to conspiracy resulting in the artificial increase in brokerage commissions. Plaintiffs, a class-action group comprised of sellers, argued that they paid excessive brokerage commissions upon the sale of their home as a result of the customary payment structure where Sellers agree to pay the full commission on the sale of their property, with Seller’s agent notating the portion of commission they are willing to pay to a Buyer’s agent at closing on the MLS or other similar system.

The Ohio Board of Pharmacy’s Latest Batch of Rules: What Providers Should Know

The Ohio Board of Pharmacy released several new rules and proposed amendments to existing rules over the past month that will significantly impact pharmacy operations. Topics range from updates to the Terminal Distributor of Dangerous Drugs license to mobile clinics to mandatory rest breaks for pharmacists of outpatient pharmacies. A summary of the proposed changes is below, along with instructions for commenting on the rules. Your BMD healthcare attorney can help write comment letters and submit the comments on your behalf as well.

Employee or Independent Contractor? New Guidance Issued by the Department of Labor

On January 9, 2024, the U.S. Department of Labor (DOL) issued its long-awaited final rule — effective March 11, 2024 — revising its prior interpretation of worker classifications under the federal Fair Labor Standards Act (FLSA). The new final rule rescinds the standard previously established in 2021, in turn, shifting the analysis of whether a worker is an employee (versus an independent contractor) of a business from a more streamlined “economic reality” test to a more complex “totality of the circumstances” standard.

Increased Medicaid Rates to Take Effect This Month for Ohio Providers

As required by House Bill 33, Ohio’s 2024-2025 operating budget bill, reimbursement rates paid by the Ohio Department of Medicaid will increase for a wide range of providers starting on January 1, 2024.