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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.


January 2025 Notice of Proposed Rulemaking Brings Notable Changes to HIPAA Security Rule

In January 2025, the U.S. Department of Health and Human Services proposed amendments to the HIPAA Security Rule, aiming to enhance cybersecurity for covered entities (CEs) and business associates (BAs). Key changes include mandatory compliance audits, workforce training, vulnerability scans, and risk assessments. Comments on the proposed rule are due by March 7, 2025.

Corporate Transparency Act Effective Again

The federal judiciary has issued multiple rulings on the enforceability of the Corporate Transparency Act (CTA), which took effect on January 1, 2024. Previously, enforcement was halted nationwide due to litigation in Smith v. U.S. Department of the Treasury. However, on February 18th, the court lifted the stay, reinstating the CTA’s reporting requirements. Non-exempt entities now have until March 21, 2025, to comply. Businesses should act promptly to avoid civil penalties of $591 per day and potential criminal liability.

Status Update: Physician Noncompete Agreements in Ohio

Noncompete agreements remain enforceable in Ohio if they meet specific legal requirements. While the AMA and FTC have challenged these restrictions, courts continue to uphold reasonable noncompete provisions for physicians. Recent cases, like MetroHealth System v. Khandelwal, highlight how courts may modify overly restrictive agreements to balance employer interests with patient care. With ongoing legal challenges to the FTC’s proposed ban, Ohio physicians should consult a healthcare attorney before signing or challenging a noncompete agreement.

Immigration Orders and Their Economic Impact on Small Business: Insights from Attorney and Former Immigration Judge Rob Ratliff

President Trump's recent executive orders, targeting immigration policies, could significantly impact small businesses in Ohio, particularly those owned by undocumented immigrants. With stricter visa vetting, halted refugee admissions, and potential deportations, these businesses face uncertainty, workforce disruption, and closures. Ohio's immigrant-owned businesses, especially in food services and transportation, contribute billions to the state economy, and any disruption could result in economic ripple effects.

Corporate Transparency Act Ruling from the U.S. Supreme Court

The U.S. Supreme Court recently ruled on the enforceability of the Corporate Transparency Act (CTA), lifting an injunction previously imposed by the Fifth Circuit. However, a separate nationwide injunction remains in effect, meaning businesses are still not required to comply with the CTA’s reporting requirements. FinCEN continues to accept voluntary reporting while enforcement remains paused.