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Billing for Behavioral health services

Compensation for billable Behavioral Health services is paid on a fee-for-service basis set out in the Behavioral Health Fee Schedule, which is Exhibit A of your Behavioral Health contract. Contact Behavioral Health for more information.

Neuropsychological testing

Neuropsychological testing is a medical benefit not authorized by the Behavioral Health Department. Its purpose is to identify cerebral dysfunction manifesting as behavioral, cognitive or emotional difficulties, and so it is used predominately for medical-surgical or comorbid conditions.

Scope of service

These are the contracted billable codes for outpatient mental health providers.

Code Description LMSW, LPC, LLP PhD Psychiatrist
90801 Psychiatric diagnostic interview examination X X X
90802 Interactive psychiatric diagnostic interview examination using play equipment, physical devices, language interpreter, or other mechanisms of communication X X X
90804 Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately 20 to 30 minutes face-to-face with the patient X X X
90805 Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately 20 to 30 minutes face-to-face with the patient; with medical evaluation and management services X
90806 Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately 45 to 50 minutes face-to-face with the patient X X X
90807 Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately 45 to 50 minutes face-to-face with the patient; with medical evaluation and management services X
90810 Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal communication, in an office or outpatient facility, approximately 20 to 30 minutes face-to-face with the patient X X X
90811 Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal communication, in an office or outpatient facility, approximately 20 to 30 minutes face-to-face with the patient; with medical evaluation and management services X
90812 Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal communication, in an office or outpatient facility, approximately 45 to 50 minutes face-to-face with the patient X X X
90813 Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal communication, in an office or outpatient facility, approximately 45 to 50 minutes face-to-face with the patient; with medical evaluation and management services X
90846 Family psychotherapy (without the patient present) X X X
90847 Family psychotherapy (conjoint psychotherapy, with patient present) X X X
90853 Group psychotherapy (other than of a multiple-family group) X X
90862 Pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy

X
90870 Electroconvulsive therapy (includes necessary monitoring) X
96101 Psychological testing (includes psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology, eg, MMPI, Rorschach, WAIS), per hour of the psychologist's or physician's time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report X
96102 Psychological testing (includes psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology, eg, MMPI and WAIS), with qualified health care professional interpretation and report, administered by technician, per hour of technician time, face-to-face X
96103 Psychological testing (includes psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology, eg, MMPI), administered by a computer, with qualified health care professional interpretation and report
X
96150 Health and behavior assessment (eg, health-focused clinical interview, behavioral observations, psychophysiological monitoring, health-oriented questionnaires), each 15 minutes face-to-face with the patient; initial assessment X X
96151 Health and behavior assessment (eg, health-focused clinical interview, behavioral observations, psychophysiological monitoring, health-oriented questionnaires), each 15 minutes face-to-face with the patient; re-assessment X X
96152 Health and behavior intervention, each 15 minutes, face-to-face; individual X X
96153 Health and behavior intervention, each 15 minutes, face-to-face; group (2 or more patients) X X
96154 Health and behavior intervention, each 15 minutes, face-to-face; family (with the patient present) X X
96155 Health and behavior intervention, each 15 minutes, face-to-face; family (without the patient present) X X
Credentialed neuropsychologist
96116 Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities), per hour of the psychologist's or physician's time, both face-to-face time with the patient and time interpreting test results and preparing the report X
96118 Neuropsychological testing (eg, Halstead-Reitan Neuropsychological Battery, Wechsler Memory Scales and Wisconsin Card Sorting Test), per hour of the psychologist's or physician's time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report X
96119 Neuropsychological testing (eg, Halstead-Reitan Neuropsychological Battery, Wechsler Memory Scales and Wisconsin Card Sorting Test), with qualified health care professional interpretation and report, administered by technician, per hour of technician time, face-to-face X
96120 Neuropsychological testing (eg, Wisconsin Card Sorting Test), administered by a computer, with qualified health care professional interpretation and report X
Last modified: 4/14/2011
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